Conditions That Change Everything
The medical, psychological, and situational conditions that require explicit assessment and modified practice—and the ones that require stopping entirely
“The general principles apply to the general case. Your job is to assess whether you are in a general case.”
— Mr. Lucius Thorne
Medical Conditions
Several categories of medical conditions materially affect the safety framework for impact practice and require explicit assessment before each encounter.
Anticoagulant medications: warfarin, rivaroxaban, apixaban, dabigatran, and related medications reduce the blood’s clotting capacity.
Impact that would produce minor bruising in a person not on anticoagulants can produce significantly more extensive bruising in someone on these medications.
More importantly, the anticoagulated individual is at higher risk of hematoma formation from blunt impact—a collection of blood in the tissue that can be painful, slow to resolve, and in some cases clinically significant.
Impact practice with a Receiver on anticoagulant therapy requires explicit disclosure of the medication, explicit discussion of the modified risk profile, and calibration of intensity to significantly lower than what would be appropriate for an anticoagulated person.
Skin conditions: active eczema, psoriasis, contact dermatitis, or any condition that compromises skin integrity in the intended impact zones affects both safety and the reliability of feedback from the skin’s response.
Compromised skin is more fragile, less able to absorb and recover from impact, and more difficult to calibrate for because its responses are less predictable.
Neurological conditions: peripheral neuropathy, multiple sclerosis, and other conditions that affect nerve function alter how the Receiver perceives impact and how reliably they can report developing problems. A Receiver who has reduced sensation in the impact zones because of neuropathy may not accurately report pain or other symptoms that would indicate developing injury.
The Striker’s monitoring must compensate for this reduced signal reliability.
Pregnancy: impact to the abdominal area is absolutely contraindicated in pregnancy.
Impact to other areas—the buttocks, thighs—requires assessment of the specific pregnancy context, trimester, and the individual Receiver’s situation, and explicit discussion with the Receiver and ideally with their healthcare provider.
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Psychological and Situational Conditions
The Receiver’s psychological state at the time of the encounter affects what is appropriate.
Significant acute distress: the Receiver who arrives at an encounter in significant emotional distress—grief, acute anxiety, significant relationship difficulty, or other acute stressors—is not necessarily contraindicated for impact.
Some Receivers find that impact in a context of genuine safety and care is particularly helpful during difficult periods.
But the encounter should be explicitly designed for the current state, not for the Receiver’s ordinary state.
The pre-scene conversation must include genuine current-state assessment, not only the parameters from previous encounters.
Dissociation history: the Receiver with a history of dissociative episodes in impact contexts, or with a history of trauma that impact might activate, requires explicit discussion and a modified monitoring approach.
The Striker needs to know what dissociation looks like for this specific Receiver, how to distinguish it from deep engagement, and what the response plan is if it occurs.