Discipline, desire, and transgression in physiotherapy practice

Abstract

Therapeutic touch has played an important part in human civilization and continues to contribute to our social relations and individual identities. Therapeutic touch has been a vital component in the development and definition of physiotherapy practice and continues to be one of the profession's principal distinguishing competencies. It is surprising then that while so much has been written about how to perform therapeutic touch techniques, little has been written about the role that these techniques have played in defining physiotherapy's professional identity. Drawing on the work of three postmodern philosophers, we offer a critique of physio-therapeutic approaches to therapeutic touch, examining why certain modes of touch were adopted by the profession in the past and not others; how the innate sensuality of touch had to be managed; and how the disciplinary technologies that surrounded the practice of massage came to define physiotherapy's professional identity. Our thesis is that the disciplinary technologies adopted by the profession in the 1890s endure today and that the profession's heavily disciplined approach to touch is now constraining new therapeutic possibilities that may be necessary if the profession is to respond to the demands of twenty-first century health care.

Notes

In this article, we refer to sensuality in both its “sexual” sense (i.e., in association with sexual arousal) and also, importantly, more broadly in relation to sensation and “being in the world” (Van Manen, 1990). An important feature of this article is our attempt to broaden the meaning and significance of words like desire, sensuality, massage, and touch for physiotherapists, to create space in which it might then be possible to think differently about our practice. Inherent in this process is a “troubling” of taken-for-granted language and an attempt to liberate words from their prior meaning and significance.

We have used the capitalized form of the word “Society” throughout the text to refer to the STM. This should be distinguished from the lower case form of society which refers more generically to the social world around us.

Noel M. Tidy's Massage and Remedial Exercise text, first published in 1932 and now in its 14th edition, is the longest continuous text published in the field of physiotherapy. It offers a generic overview of physiotherapy in a range of contemporary practice areas, and so provides a useful ongoing barometer of the profession's interests and involvements (Tidy, 1932).

Nobel Prize winning author Jean-Marie Gustave Le Clézio's writings draw heavily on Deleuzian ideas. Wandering Star, the story of a chance meeting between an Israeli and Palestinian girl, emphasize the importance of indigenous marginal cultures, the virtues of nomadic freedom, and our ethical responsibility to open space for new modes of expression and thought.