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The Three C's
©1992, 2000. All Rights Reserved
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One day at the end of 1991, as I was moving from San Francisco to Champaign, my old car, Tillie, a '73 Volvo four door sedan, started experiencing trouble. The night before, Tillie's battery had died while I was getting gasoline and I had to get it charged up again. The mechanic at the all-night truck stop thought I might need a new alternator. He advised me to get one installed the next day, before continuing with my trip. |
Very early the next morning I went to the local auto parts store only to learn that they didn't have the part. They could order an alternator from the distributor but would not receive it for a few days. The gentleman at the store was kind enough to call around for me; after several calls, he found the necessary part at the Volvo dealership twenty miles away. I called them. It was the Friday before New Years and they regretfully informed me that they were too busy to help me. I thought of having to wait three days, the three days I had hoped to be driving across country so that I could reach my new home with enough time to unpack and settle before beginning to teach.
I decided to ignore the bad news from the Volvo place and drive over, hoping that the mechanics at the dealership would take pity on my situation and help me out. Luckily, they did. When I was standing in the service department manager's small office, I noticed a sign on the wall. It said:
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CONDITION CAUSE CORRECTION |
When I asked him what it meant, he told me that these Three C's were designed to help the customer understand what he or she was paying for when presented with the repair bill. When the customer is paying, the mechanic should address these three factors: the cause of the problem, the general condition of the car (especially as it relates to the problem) and the correction that was made to eliminate the problem.
The Three C's symbolize lineal causal thinking. This kind of thinking assumes that an event, or effect, has a prior cause, that you can trace a path from the effect straight back to the cause, and that this cause is localized in a specific place. Here, the reasoning of car repair mirrors the logic of medical diagnosis: a problem has an identifiable cause and its resolution depends on the cause being identified and rectified. This is inherently a reductionistic approach: a complex situation is reduced to a description of the elements that comprise it.
A mechanical problem with a car can easily be understood in these terms: The car won't start. Since it doesn't turn over at all, we conclude the battery is dead. The lights and the radio not working confirm this. From the dead battery, we can work our way backward to the cause. We ask why the battery is dead. Eventually, the mechanic deduces that Tillie's alternator is not charging the battery, therefore it is broken and needs to be fixed.
However, the problems we often deal with in rehabilitation—as well as those of improving human performance in the arts, in sports and in human learning—do not necessarily respond to this approach. For example, stiffness and reduced range of motion are common problems following surgeries, accidents, or traumatic injuries. This unconscious neuromuscular response, often called muscular splinting, can persist long after the immediate injuries have healed. For instance, many years after a surgery to remove a bunion, one of my students began experiencing low back pain and limitations in mobility and flexibility. In this situation, whether it is referred to as favoring one leg, limping, or adaptation phenomena, the cause of the problem is difficult, if not impossible to localize. Does the foot cause the problem? What if the surgery was successful and the foot is no longer uncomfortable, but the person continues to avoid weight-bearing on the area which, after surgery, had been painful? Is the problem in the back? What if there is no structural basis for the problem?
Some problems cannot be traced back to a specific, local cause. Rather these problems arise from the way a person moves. In these situations we can say the problem is a consequence of how a person functions, of what she or he does, and how he or she goes about doing it. To resolve this type of problem requires a shift in thinking. We must understand the nature of the body-as-movement-system and the relationships that underlie it.
The shift from reductionistic to systemic pattern finding is analogous to one that happened in the branch of psychotherapy known as family systems therapy. Where once it was thought necessary to treat an individual with problems, it is now recognized that the individual is often not the cause of the problem, but rather this person is understood as expressing something that is amiss with the functioning of the family. The problem comes from the relationships between the family members and the patterns that they form—not from any one person alone. This problematic person is referred to as the identified patient.
In much the same way, many so-called "physical" problems are mislabeled. The difficulty arises from the very act of looking for a problem's cause and trying to find its specific location. From that moment, either the problem is found, so that some thing is blamed as a specific structural basis for the malady, or, worse yet, no specific pathology is found and the problem is labeled as psychosomatic. Borrowing from the family therapists, in rehabilitation, bodywork, movement education, and so on, we can label the presented problem as the identified problem. The identified problem comes from how the person is moving, from the relationships between the parts of the body and the patterns that they form—not from any one part alone. With this kind of dysfunction the identified problem is not the cause; it is a consequence. The identified problem arises from the movement, feeding off it and draining it of power and gracefulness.
The genius of Moshe Feldenkrais was realizing that our troubles are not due simply to physical defects, disease, and degeneration. Seeing how we move and understanding how we can move, Feldenkrais understood how dysfunction arises from our limitations—in perception and in motion—and how our difficulties are embedded in the very ways we sense and move. (Even when there is a particular physical problem, we can consider how the person moves and how this may contribute to the trouble.) This perspective is a systemic one, a point of view that understands the person in motion as an integrated whole, as a unity. Resolving an identified problem requires a non-reductionistic approach for assessing the pattern and systemic strategies for changing it. We need a way to proceed that begins with this understanding, a way of proceeding that looks at the relationship between how someone moves and the difficulties they may be experiencing.
