Great Post! Relief as a Reward: hedonic and neural responses to safety from pain
Via Body in Mind
Lorimer reviews a study that studied brain responses to a warning cue before an unpleansant stimulus and a "just kidding cue. They rated the pleasantness of their relief 9 second later. The responses were correlated with pessimism scores. Turns out the more pessimistic of the sample experienced greater changes in the fMRI.
He also asks if more pessimistic people eventually become "addicted" to manual therapy as they experience a greater change from the initial "not expecting much" to potential rapid change. I'm sure this is possible, and it's all up to the clinician and their business model. I discharge most of my patients when they are functionally ready and have met my and their goals. I have some patients who continue on a maintenance basis like runners who come in as needed for some STM. The majority of patients get discharged with HEP, whether or not they want more manual therapy, because I believe and try to educate them that it is not needed if they are compliant with their HEP.