published 08/15/09
Modality Empires
A tradition of ego-driven treatment methods in manual therapy
by Paul Ingraham, Vancouver, Canada MOREclose
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
“Modality empire” is my own term for a proprietary method of manual therapy — a sub-discipline — championed and promoted by a single entrepreneur who usually suffers from a serious case of healer syndrome. If you have a chronic pain problem, it’s an important concept to understand, because so many of the therapies that will be offered to you are the products of modality empires.
While there are many taxonomies of alternative medicines, one thing almost all alternative therapies have in common is they are originally the de novo discovery of one lone individual.
Dr. Mark Crislip, “The Marshall Protocol” on Science-Based Medicine
Big promises
Most modality empires make big promises of healing powers, and usually make their money by selling expensive therapy and workshops. Professionals are sold on the opportunity to purchase credibility in the form of increasing “levels” of certification, but the quality of these certifications is dubious and unregulated.
Modality empires usually revolve around an overly simplistic notion of how the body works and how it might be fixed. In particular, a substantial majority of modality empires are grounded in “structuralism”: the emotionally compelling idea that our problems are caused by being “crooked” in some way, and that all our problems will go away when we are “straightened” by therapy. Unfortunately, there is a great deal of evidence that this view of chronic pain is dubious at best. See Your Back Is Not “Out” and Your Leg Length is Fine.
Classic examples of modality empires include Ida Rolf’s ROLFING®, John Barne’s myofascial release, and John Upledger’s craniosacral therapy. Sometimes a modality empire is particularly unoriginal: re-packaging old ideas for a new generation of workshop consumers, like Paul St. John’s take on trigger point therapy (St. John Neuromuscular Therapy™).
Modality empires are businesses
A modality empire is as much a business model as a method of helping people, and perhaps much more. There is a great deal of overlap between modality empires and quackery.
History has shown us time and again that what drives the popularity of a modality empire is not the efficacy of the treatment method, but how well it is promoted. Once in a while, a well-promoted modality empires hits the big time and become full-fledged profession, chiropractic being the most infamous example: chiropractic began its life as the modality empire of DD Palmer, and then his son BJ, and they spent decades bringing it to the status of a regulated profession. The Palmers were certainly marketing geniuses, but they were promoting many ideas that have been long since been abandoned as useless, even by some chiropractors.1
History has shown us time and again that what drives the popularity of a modality empire succeed is not the efficacy of the treatment method, but how well it is promoted.
Why aren’t customers cynical about modality empires?
What puzzles me most about the promotion of modality empires is how effective they are at fooling people who are cynical about other kinds of businesses.
Modality empires actually attract customers — both therapists and patients — who generally hate The Man, corporate greed, and especially Big Pharma. Yet they give a pass to these modality empires, many of which are blatantly corrupted by ego (at least) and by massive profits in some cases.
It’s probably just because modality empires are able to successfully cast themselves in the role of the underdog. Also, the marketing of most modality empires is usually finely honed by market forces, and the successful ones are successful precisely because they have found the right emotional buttons to push. Basically all modality empires are sold on the strength of an emotionally appealing idea.
Notes
- The End of Chiropractic. Hall. 2009. A well-written analysis of the significance of an important paper written by three chiropractors and a PhD (Mirtz et al) about the scientific bankruptcy of subluxation theory. Return to text.