Associate Professor David Butler
B.Phty, M.App.Sc, EdD
Associate Professor, University of South Australia Director,
Neuro Orthopaedic Institute, Adelaide, Australia
Associate Professor David Butler has blended a life of writing, teaching, clinical work and dabbling in research. Education is his forte and he has taught over 40,000 health professionals world wide and delivered over 50 keynote addresses at international conferences. He would love to retire to fish, to sit on boulevards pondering life while sipping Pinot, but the revolution in the understanding of pain and the increasing awareness of the power of knowledge and potential for change keep him charged. It’s the question of ‘how do we best help people learn’ that drives him.
David has written “Mobilisation of the Nervous System” (1991), “The Sensitive Nervous System” (2000) and with co-author Lorimer Moseley, “Explain Pain” (2000, 2103), “The Graded Motor Imagery Handbook” (2013), “The Explain Pain Handbook: Protectometer” (2015) and in 2107 “Explain Pain Supercharged”. He is an honoured member of the Australian Physiotherapy Association.
His current focus is around adult conceptual change, diagnostic and therapeutic metaphors and pain associated linguistics. David is internationally well known and respected as a lively speaker with a polychromatic dress sense, capable of transforming the most turgid of modern pain sciences into instantly relevant and clinically applicable information.
Practical Applications of DIMs and SIMs
A clinically useful pain definition is “we will have pain when there is more credible evidence of danger to our body then credible evidence of safety”. Perceptions of credible evidence of danger (DIM = danger in me) and credible evidence of safety to our body (SIM = safety in me) emerge from many domains including visual, auditory, cognitive and social as well as input from injured body parts. Logical therapies should aim to remove or reduce the dangers (DIMs), enhance the safety (SIMS) and/or turn DIMS into SIMs.
This breakout session provides a practical method of identifying, categorising and managing DIMs and SIMs. Multiple examples are provided with a focus on the things we hear and the things we say, with many more examples expected from an interactive group.
Shifting Tough Misconceptions – The Example of OA Knee
Education that downregulates an overprotective neuroimmune system and facilitates safe contextually variable activities has increasing scientific support. We all educate, but there is also evidence that we could be doing it a lot better.
The older view of OA knee is that of a mechanically driven progressive local “wear and tear’ situation where the outcome is predetermined – usually surgery or “live with it”. A newer view is that of a systemic process of chronic, low grade inflammation with multiple contributors including diet, misconceptions, enhanced immune activity and one where the outcome is not predetermined.
The shift from the older to the newer view is not easy – for health practitioners and the public. An educationalist would consider that an ontological categorisation error exists whereby knee OA is regarded as an entity rather than a process. This is an age old philosophical discussion which can be applied to many health issues such as stroke and fibromyalgia.
Educational psychology provides strategies to facilitate the modern view. They include holistic confrontations, intersection discoveries which link old and new views and access to emergent thinking which uncovers likely multiple contributions but also numerous ways to deal with the problem.