81 Intensities

At the ‘heart’ of any entity is its essence. But because this always exceeds our ability to capture it, or fully know it, it would wrong to think of the essence as representing a thing’s identity. Identity is a concept that came from Enlightenment science, and is too definitive to be useful here. Instead, Deleuze and Guattari talk of an entity as expressing a number of intensities. These are driving forces or concentrations of vitality rather than physical structures, but they are still specific to the entity itself. It is the intensities inherent in touch, for instance, that has seen it persist as a feature of human society for millennia. So, although touch has many different meanings and properties that far exceed human experience (its surface adumbrations), it has intensities that give it its distinctive power. We know touch is different to annular ligaments and cardiac arrhythmias, feelings of hope and experiences of pain, or goniometers and patient records, because of its intensities.

The theoretical shift that this thinking makes possible, allows us to completely re-conceive physiotherapy. Rather than looking to holistic models of practice to reconcile competing philosophies of the body, the mind, and the social, with all of the attendant problems outlined in the earlier chapters, we can focus instead on two approaches:

1. Your intensities

   What are the key intensities underpinning your physiotherapy practice?

   What would you need to remove from the layers of theory and practice we have added to the profession over the years in order to get closer to the intensities at the heart of your practice?

   The first involves locating the intensities at the heart of the physical therapies. We know from our own practice just how powerful the physical therapies can be. How many times have we encountered an intensive moment of transformation, when some ineffable event occurred and a patient made a remarkable leap forward? The physical therapies are pregnant with intensities. Perhaps this is the reason why we have always sought to contain them, regulate them, and standardise their delivery? But, of course, the physical therapies will always exceed our attempts to capture and colonise them because they are radically transgressive and irrepressible ^[1]. They are ‘ungovernable energies and intensities that emanate from a series of unrestrained and often unpredictable conjunctions’ ^[2]. This is why they have been so consistently used by cultures throughout the world as vehicles for healing and care. Locating the intensities at the heart of this kind of transformative power would be no easy task. As mentioned earlier, the essence of an entity like touch and movement can never be fully grasped, and efforts to allocate new meanings and properties to the physical therapies would only serve to add surface layers to them.

2. So, the second approach involves the removal of as many adumbrations wherever we encounter them, so that the intensities at the heart of the physical therapies can be more strongly felt. This, again, is no easy task. Every definition, system of regulation, practice standard, best practice guideline, theoretical framework, textbook example, and model we have used in the past, has territorialised the therapies. They have shaped the way some authority or other has wanted us to experience the entity, and has sought to close off possible alternatives. All of these need to be unpacked, critiqued, and ultimately removed, leaving us to experience the physical therapies in their most unencumbered state.