What is your intent when adjusting a patient? What’s on your mind? What are you hoping to achieve? What are you visualizing? What outcome are you imagining?

Since I don’t adjust patients, I’m at a slight disadvantage here. However, it occurs to me that no other aspect of your relationship with patients is more telling. Not only does your intent reveal how you see yourself in relation to patients, it exposes your heart and with it, your deepest motives. A practitioner’s intent is often a helpful clue of what may be the underlying cause of a plateaued or under performing practice.

Intention matters.

This is the spiritual side of healing. If you are in fear, scarcity, anger or resentment a patient’s experience (and the effect of your care) will be different than if your care is delivered in an atmosphere of curiosity, generosity, trust and love.

Consider the difference between cutting the grass, whacking down the green stuff so you can watch the game, with mowing the lawn, cross cutting, trimming around the flower beds and grooming it to look its best. The former is purely a mechanical act. The latter is a form of art.

Or consider a hamburger “assembled” by clock-watching teenagers at a fast food restaurant and a hamburger grilled at home in which love is cooked into it. Same ingredients. Different energy. Different effect.

What is your intention when you add energy to a patient’s spine at opportune times and places?

Avoid hurting the patient :: Don’t laugh. There’s an entire generation of chiropractors graduating from several so-called chiropractic colleges who imagine their job is to refer patients to “real” doctors. Their adjusting skills are rudimentary and they have been taught to fear the damage that adjustments can do. Terrified that their adjustments might result in a lawsuit, they are quick to refer patients to other practitioners or rely on less invasive therapeutics. Cases that chiropractors 50 years ago would routinely adjust seem far too risky, requiring a medical practitioner.

Make money :: If adjustments are merely a means to pay off your student loans, good luck. Patients can tell that you’ve made the interaction about you and your needs rather then them and their needs. Worse, when you set your sights so low, you rarely create much affluence beyond merely being able to pay your bills. For all the schooling and student debt, you’ve merely landed a job—with a tyrant—you, as the boss. If your goal is survival, you probably will. But little else.

Get the patient to like me :: If you suffer from chronic low self-esteem, this may be your Achilles heel. Apparently, either “if I don’t confront, avoid giving specific direction or challenge their beliefs, they’ll like me,” or “if patients like me they will more likely follow my direction.” Either way the practice never gets out of first gear. It’s a common affliction among those who have mostly pain relief practices and often suggest that “…we give chiropractic a try and see how goes.” Very little confidence or leadership exhibited here.

Put a wayward bone back :: The danger here is that it pits your educated mind against the patient’s innate intelligence. In other words, since bones are static structures that move only when moved by muscles, and muscles only fire when commanded by the nervous system, your intent may be in conflict with the patients’ body’s intent. If the physical, chemical or more likely emotional, stressor is still present, projecting your notion of alignment or biomechanics onto the patient’s spine is likely to be unsuccessful. Pop quiz: is vertebral subluxation a sign their body is suddenly dumb and needs to be fixed, or is subluxation a brilliant and creative defensive strategy used by their body to cope with stress?

Relieve their symptoms :: Besides being the practice of medicine for which chiropractors aren’t licensed (or insured), using adjustments to treat pain is fraught with uncertainty. Unlike an opioid, predicting if or when it will “work” is dependent upon countless factors outside your control. This surrenders control (and the your confidence) to the subjective assessment of the patient. An unfortunate side effect for such an intent is a practice with a relentless demand for new patients—yet lacking the social authority of a medical practitioner.

Restore proper structure :: This is a common intent among those who hope to rehabilitate lost cervical curves or reduce fixations revealed by radiographs or orthopedic tests. The “ideal spine equals ideal health” mantra provides a seemingly objective way to measure results that are seen as a higher calling than the baser intent of merely relieving symptoms. Unfortunately, this often makes chiropractic about bones rather than nerves; the physical rather than the spiritual. By isolating and “treating” the spine, you may have inadvertently fallen for the allopathic notion of attending to the problem in the patient, rather the patient with the problem.

Revive their ability to heal :: Arousing a patient’s capacity to self heal by reducing nervous system interference holds great promise. In fact, it was how chiropractic got licensure as a separate and distinct healing discipline that deserved to exist outside of medicine. Recognizing that you’re not “fixing” spines and that the real doctor is the patient, is grounded in the obvious truth. By respectfully adding energy to their spine, and trusting their body to use (or not use) that energy to help “right itself,” is the essence of chiropractic. When your intent is to release, rather than impose; to liberate rather than control, you become a facilitator, honoring the patient, respecting their sovereignty and possessing the proper emotional detachment that allows you to help a lot of people.

Your intention reveals whether your practice exists to serve you or to serve patients. When its primary focus is to get your needs met first, whether financial or psychological, its influence is constrained. It can’t flourish. You may have confused cause with effect.