I love Christmas, but as we edge closer to the big day, one thing that I find hilarious and annoying in equal measures is…..perfume and aftershave adverts.

Seriously, could they be any more pretentious? Any vaguer?

On the one hand, I think they must make people buy stuff, or they wouldn’t pay for the adverts, but why would a model looking confused and a voice-over talking random nonsense make you buy a perfume?

Or is it the emperor’s new clothes/advert?

The advertising companies have managed to convince a few companies that this is the done thing (social proof), so all the competitors do the same just in case.

For me, this is all fluff and no stuff, it is smoke and mirrors, a marketing sleight of hand to convince you of the power a £75 bottle of chemicals can exert and make you a sexier person.

Personally, I prefer Fry and Laurie’s take on it



But the adverts remind me of the ever-present gurus on stage dishing out pearls of wisdom about how to practice.

This, I suspect, is a Chiropractic-centric issue and largely thanks to our North American friends with an occasional Australian in the mix.

You see, I hear the same lines being trotted out again and again by usually non-practising gurus about how we should practice.

The tricky part is that the following three statements all contain truth within them, but they are incomplete and somewhat misleading on their own.

Truth (in this context) is not pure or straightforward but devilishly complex and murky.

1: You must adjust/treat with the right intention.

2: You must adjust/treat with absolute certainty.

3: You should always be in a flow state.

Now then, let’s be clear, these three statements on their own are correct and valuable.

Trying to examine & affect someone’s neuromechanical system while thinking about shopping or what is for dinner is going to make the assessment and care you deliver worse than if you talk to them with certainty (surgeons are the masters of this, they are kingpin bulls****ers) and are in a state of deep, unconscious focus (flow state) and connected to the exam and treatment.

The issue I have is the gurus are also suggesting that it is the only thing you need to worry about.

In fact, I have heard many times, the treatment type or form doesn’t matter as “it all works”.

So you can deliver any old cack for treatment as long as you smear it with their secret three sauces of certainty, intention and flow.

In my opinion, they are advocates of therapeutic inadequacy.

It is a get out of jail card for borderline clinically incompetent clinicians.

There is no need to work on your adjusting technique or that myo-fasical release or rehab or spot signs of mental illness or adverse childhood events.

Just do anything with certainty, the right intention, in a flow state, and you can also expect miracles, just like the one the guru talked about on stage (the same one they trot out at every conference).

Imagine if you needed spinal surgery, and at the consultation, the dialogue went something like this:

Surgeon: “Well, the bad news is you do need surgery, fusion in fact. But the good news is, a few years back, I heard a surgeon lecture who no longer operates. He retired mid-career to help other surgeons enjoy their clinic more (they can have more impact that way). At the time, I was highly focused on my analysis of the patients’ issues, radiology and surgical technique, but they told me that all surgery works the same. “

You: “errrrrr…….”

Surgeon: “So anyway, I didn’t really bother checking the MRI and I will not be performing any meaningful exam on you now to determine where to fuse or any exam after the surgery to see if what I did was correct. The most important thing is to fuse your spine with certainty and the right intention. Remember, all surgery works. Plus, to help me get into a flow state, I have decided to have four other patients in the operating room all at the same time.”

You: “What the actual f**k……”

The best remedy for this, in my opinion, is an honest assessment of the patient before and after the treatment.


No matter what technique you use, if it had a good therapeutic affect, something should have changed (the very acute patient may be the exception here).

These changes in ROM, strength, and pain should have some degree of sustainability between visits and ideally correlate.


But if they are getting minimal changes or no changes after the visit and they do not sustain, we are missing something.


Doing this can be scary, but ultimately rewarding. There are so many clinicians out there terrified they might not be quite as good as they think they are.

Illusions are comfortable, the truth is not.


Core commandments 1 and 2 are:


You will do well to remember the TRIAD of health.


And remember, our lives have changed beyond anything our hunter-gatherers evolved in.


Our focus at ACN is the metabolic side of health and specifically how it affects the ability of our neuromechanical intervention to work as we know it should do.

This is the neuromechanical metabolic interface.



– Pick a few techniques and get really, really good at them, work towards clinical mastery.

– Choose results, not theory. Did your care actually do what it should have done given your clinical theories?

– Do talk to your patients with certainty, do have the right intention, do foster a flow state, but those alone will not get your results and deep down you know this is truth.

– Keep your eyes peeled in the new year for our next intake of CCCN members.