Perhaps the greatest challenge for the scientific investigation of our work is its essential holism: the multi-dimensional and holistic attributes that give structural integration (SI) its conceptual richness also complicate the scientific assessment of its results. Segmentation of reality and isolation of phenomena, often used for controlling multiple variables, in our context pose the risk of losing the whole, of overlooking the essence of the work. What we need is a scientific approach consistent with our paradigm.
To meet this challenge, the ABR (Brazilian Rolfing Association), in partnership with Centro Universitatio Italo Brasileiro (Uniitalo), São Paulo, Brazil, created a postgraduate program for Rolfing SI. This program is open to students in the last stage of their professional certification training (Unit III), as well as to practicing professionals. Program participants take university courses in scientific methodology and pedagogy and apply what they learn in the execution of formal case studies on the process of a class client or client in a practitioner’s clinical practice. Those who complete it are awarded the equivalent of a master’s degree.
The thirteen participants in our first class, which began in 2010, investigated topics running the gamut from the effect of Rolfing SI on low back pain or adhesive capsulitis (frozen shoulder); to how Rolfing treatments might contribute to the management of chronic diseases such as bipolar disorder and multiple sclerosis; to the nature of the Rolfing process as a therapeutic event which, like psychoanalysis, requires cooperation and participation between the client and practitioner as co-responsible agents. The 2010 studies were discussed in detail previously.1 Here, we present the abstracts of the case studies from the second class, which began in 2011.
The case studies for our postgraduate program are far more extensive than those of the basic certification training at the Rolf Institute®. At Uniitalo, the student researches a specific problem by engaging potentially useful theories, raising questions, developing hypotheses, and seeking methods to investigate them. The student then presents and discusses the outcomes according to accepted scientific parameters. The case study is both a method of investigation and the investigation itself. In both scope and level of effort required, the post-graduate program case studies are comparable to any other master’s thesis.
As the case studies show, their authors have accepted the challenge of employing a scientific approach consistent with our holistic paradigm. Each found a focus, defined a theme, and investigated a problem; and from this focus, observed correlations among the multiple dimensions of Rolfing SI and its taxomonies of access (structural, functional, psychobiological, and energetic). Even as they employed impeccable scientific methodology, they displayed an embodied holistic attitude, one congruent with the philosophical stance and conception of the human being that are fundamental to Rolfing SI. These researchers walked their talk, showing by example that science and holism can coexist, and that there can indeed be a science regarding a holistic activity.
The 2011 program participants and abstracts of their inquiries are set forth below. The full case studies are available in Portuguese (with abstracts in English) at the Ida P. Rolf Virtual Library for Structural Integration (www.iprlibrary.com or www.pedroprado. com.br); at the ABR’s library; and at Uniitalo Library’s special collection of postgraduate program papers.
The contribution of Rolfing SI toward postural equilibrium, ease of locomotion, and quality of life in an adult with cerebral palsy
Investigated by Rosângela Maria Baía, Certified Rolfer™, Rolf Movement Practitioner
This case study investigated how Rolfing SI, a holistic approach of reorganizing human structure in the field of gravity, might help functional adults with spastic cerebral palsy (CP). Our hypothesis was that by organizing muscular tonus, we could improve the subject’s balance and locomotion, thereby allowing the subject the possibility of a revised perception of her own movement – which might, in turn, enable better movement. CP patients have often carried since childhood a body image constrained by their diagnosis, and even by the very name of their disorder. We expected that a revised body image would allow the possibility of better postural habits, refined anticipatory motor activity, and improved motor skills – as well as produce an overall better quality of life.
The subject, an active fifty-two-year-old woman, received twenty-two sessions of combined myofascial manipulation (light to moderate touch) and movement education.
In each session, the practitioner sought to observe and track, and ultimately to guide, the subject’s movements in such a way as to redistribute body tonus. With more balanced tonus, the subject experienced less tension, spasticity, and movement inhibition, and seemed less susceptible to injury. She also reported an overall improvement in her quality of life.
We measured the outcome of the treatments with the questionnaires developed at the Center for Treatment, Research and Education in Rolfing SI (NAPER, São Paulo, Brazil)2; the WHO-QOL survey (short form in Portuguese)3; observation of the subject in routine activities; and analysis of still photos and videos. The findings of this study and others like it might allow those treating functional CP patients to integrate Rolfing SI into a multidisciplinary protocol to improve both motor activity and emotional health.
The contribution of Rolfing SI to the treatment of chronic pain associated with non-structural scoliosis
Investigated by Adriana Toyoko Higa, Certified Rolfer, Rolf Movement Practitioner
This case study examined the effect of Rolfing structural and functional integration on a subject with non-structural scoliosis (i.e., non-ideopathic scoliosis attributable to patterns of body use) to test the hypothesis that the treatments would reduce the degree of scoliosis, mitigate the associated chronic pain, and enhance the subject’s overall quality of life. The subject received both Rolfing SI (systematic myofascial release) and Rolf Movement functional integration (in this case, to enhance the subject’s attunement to sensory perceptions from sight, hearing, touch, smell, taste, and proprioception). The subject was taught to use the senses both to find support for the head and to perceive opposing forces both upward (lift) and downward (support) acting on the body. While this sensory and kinesthetic awareness gave the subject an enhanced sense of verticality, which helped her to maintain an upright posture, both the subjective discomfort and objective degree of the scoliosis diminished.
Following a series of ten structural and five functional treatments delivered over a period of three months, both quantitative and qualitative data were gathered. The quantitative data, consisting of radiographic assessment of the COOB angles before and after the process, revealed a reduction in the degree of scoliosis. Before the process, the scoliosis was measured as a leftward dorsal (thoracic) convexity of 12° and a rightward lumbar convexity of 17°. After the process, the scoliosis was measured as a leftward dorsal (thoracic) convexity of 5° and a rightward lumbar convexity of 7°. The qualitative data confirm less subjective pain, with the reported pain level reduced from ‘10’ to ‘3’ on the Visual Analog Scale. The subject experienced improved quality of life as measured by the WHO-QOL questionnaire. Finally, the subject reported gaining a sense of verticality. The data support the hypothesis that Rolfing structural and movement integration can effect positive changes in persons with non-structural scoliosis, and further studies of additional subjects should be made in order to validate the hypothesis more generally.
Rolfing SI in the treatment of limited range of motion in the shoulder following radical mastectomy for breast cancer
Investigated by Maria Ayako Sakuraba, Certified Rolfer, Rolf Movement Practitioner
Many mastectomy patients suffer diminished range of motion at the shoulder on the side of the surgery, which leads to functional limitations and diminished quality of life. In this case study, we tested the hypothesis that Rolfing SI might restore range of shoulder motion to such a patient, and thereby reverse the functional limitations and improve the patient’s quality of life. The subject, a fifty-six year-old woman, suffered pain and dysfunction in her left shoulder following a radical mastectomy (left breast) for ductal breast cancer.
The subject received a ten-session series of Rolfing SI according to the protocol commonly known as the Rolfing “Recipe.” Data regarding the subject’s shoulder pain and dysfunction before and after the series consisted of still photographs, the subject’s reports of pain on a numerical scale of 1-10, and goniometry to assess the amplitude of joint motion. Data regarding the subject’s quality of life before and after the series were gathered through the EORTC-QLQ-C30/BR23, a questionnaire designed specifically for breast cancer patients.
The data indicated improved range of left shoulder motion in flexion, extension, and abduction, better overall postural alignment, reduced pain, and significant improvement in quality of life. This supports the hypothesis that Rolfing SI can be a valuable therapeutic technique to restore range of shoulder motion to mastectomy patients, and thereby reverse their functional limitations and improve their quality of life. The positive results presented here suggest that this study should be expanded to a larger and more meaningful sample.
The benefits of Rolfing SI for adult victims of childhood sexual abuse
Investigated by Rúbia Sayuri Takashima, Certified Rolfer, Rolf Movement Practitioner
The sexual abuse of children is increasingly recognized as an important social problem. Recent studies have reported that perhaps 20% of women and 10% of men suffered at least one episode of sexual abuse as children. This case study describes the discomfort and dysfunction of one childhood incest victim, whose symptoms included muscle pain, difficulties in relationships, low self-esteem, feelings of guilt and anger, and distorted body image. The study documents the effects of thirteen sessions of Rolfing SI, consisting of systematic myofascial release combined with movement education emphasizing the subject’s sensory perceptions.
During the Rolfing series, the subject gained access to memories of the sexual abuse, which memories allowed the subject to better understand current relationships with others and with the environment, and to recognize that current bodily tension, fear, and insecurity were related to the past abuse. Because attention to perception about the body was a key component of the Rolfing work, this case study suggests that it might have been the subject’s heightened and acknowledged perception that allowed the subject access to the memories of childhood abuse and indicates the potential benefits of further research to isolate as a variable this particular component of Rolfing SI.
Rolfing SI and the concept of “singular experience”
Investigated by Maria Lucia Moreira Merlino, Certified Advanced Rolfer, Rolf Movement Practitioner
Rolfing SI integrates the human structure and retrains the proprioception through a system of connective-tissue manipulation and somatic and movement reeducation. Persons who experience Rolfing SI commonly report heightened physical and emotional sensations, and also that they sense possibilities for new ways of using, moving, and being in their bodies. This study investigates the relevance of singular experience, as a pedagogical concept, to the Rolfing process. This concept was developed by American philosopher and educator John Dewey. It is his term for the personal experience of satisfactory completion of a process, such that the person recognizes the process as a contained and unique event amenable to acknowledgement, description, and reflection. The pedagogy of Rolfing SI is unlike that of other forms of training, the former being more of an art than a technique. Integration of the structural changes requires some time for relearning, as the sensorimotor system adjusts.
However, we hypothesize that for the subject to retain and not discard the insights of a singular experience, both the insights and the sensations that facilitated them must be recognized and their importance acknowledged. The two case studies document the occurrence of singular experience and how it was addressed in order to advance the subjects’ processes during their Rolfing series. Each subject received fifteen sessions of Rolfing SI. Outcomes were evaluated based on before-and-after questionnaires, the researcher’s notes during the series, and the subjects’ own summary accounts of their experiences. The data indicate that Rolfing SI can help subjects to build, recognize, and appropriate new internal bodily coherences, as well to observe and acknowledge the importance of bodily sensations as guides for actions and physical attitudes. In addition, the data substantiate the importance of the singular experience in self-recognition. Finally, the researcher identifies some approaches for facilitating the emergence of this quality of singular experience during Rolfing sessions.
Author’s Note: Special thanks to Heidi Massa, Certified Advanced Rolfer, for her collaboration on the conception and preparation of this piece.
Endnotes
However, we hypothesize that for the subject to retain and not discard the insights of a singular experience, both the insights and the sensations that facilitated them must be recognized and their importance acknowledged. The two case studies document the occurrence of singular experience and how it was addressed in order to advance the subjects’ processes during their Rolfing series. Each subject received fifteen sessions of Rolfing SI. Outcomes were evaluated based on before-and-after questionnaires, the researcher’s notes during the series, and the subjects’ own summary accounts of their experiences. The data indicate that Rolfing SI can help subjects to build, recognize, and appropriate new internal bodily coherences, as well to observe and acknowledge the importance of bodily sensations as guides for actions and physical attitudes. In addition, the data substantiate the importance of the singular experience in self-recognition. Finally, the researcher identifies some approaches for facilitating the emergence of this quality of singular experience during Rolfing sessions.
Author’s Note: Special thanks to Heidi Massa, Certified Advanced Rolfer, for her collaboration on the conception and preparation of this piece.
Endnotes
The Case Study Method: Year Two[:]
To have full access to the content of this article you need to be registered on the site. Sign up or Register.