Crazy Deep Models

[Nick]

Deep model: description of those processes occurring beyond our vision or sensation that ultimately account for what we observe empirically.

This is a definition I first heard Barrett provide 5 years ago on his course. He added the caveat that it should never violate physical law. Seems to be quite apparent - especially for physical therapists. I mean, we aren't spiritual mediums...or are we?

Today I had a patient describe how her previous therapist felt her issue (stiff shoulder post-fracture) was related to past life trauma! Amazing. I normally can muster a bit of restraint in such situations, but could not hold back my distaste for this kind of meme propagation. The patient sort of recoiled at my critique and said she chooses to leave it open to possibility because no one really knows. What? No one knows that a shoulder might get stiff post-fracture? Or that pain might persist beyond healing in the absence of a past life issue? Or that there may be a better means to deal with this than past life regression? She then went on to describe how she attended a workshop on this where people had all kinds of stories about their past lives. I told her that the problem with stories is that they often aren't true.

It continues to astound me that therapists and patients alike will not only tolerate this kind of thinking and acting, but in many cases actually prefer it. This is an extreme example - there are many, many more. I'd like to hear some of your examples and your ideas for meme-busting. My less-than-tactful approach this time fell a bit flat.

Nick

[Crazy Pole]

Hi Nick,

Interesting story, and unfortunately, probably not all that uncommon. One thing I wonder about is whether or not your patient's interpretation of the previous PT's thoughts were consistent with the PT's thoughts.

I have found that, despite my best efforts otherwise, often my message (which makes no mention of past life trauma) doesn't seem to always be reflected accurately when patients complain to my supervisor about me. That is something that I am certainly trying to remedy.

Past life trauma explanations, however, should raise some concern. That seems somewhat hard to misconstrue.

Wes

[Diane]

I think one's response to stuff like this should vary depending on
1. Are they checking out your particular belief system to see if you concur (objective info seeking)?
2. Are they just sharing with you something near to their heart (their own belief system at the moment)?
3. Are they trying to convince you their "other" therapist is right (proslytize)?

I think all three situations require a bit different level of sensitivity. I think it's ok (if you aren't already sure) to ask them why they are asking you about this. Who knows, it could lead into some good info about them and how they think that might help you somehow to make sense out of their pain issues or what have you.

A cheerful and simple "not within my scope" kind of answer, then smoothly and immediately changing the topic, bringing the conversation back to their bit you are treating, what they might be sensing right now, will usually preserve your own boundary without making your patient feel bad/without harming the therapeutic container you've built with them. It lets them and you both off the hook gracefully if your beliefs collide at right angles to theirs.

[christophb]

I've had a few reactions like this in the past... like Monday. My personal sensitivity to such matters vary, some days I can let it slide an let the care speak for itself, other days... I just reassure myself that at least the reaction was authentic and consistent with my treatment philosophy. Where I am on the spectrum and why, well, I hope to discover that with more maturity. Right now I usually blame sugar or bad feng shui. Most of my battles seem to be waged with narrow minded orthopedists... I would welcome a shaman's memes to deconstruct.

Chris

[Luke Rickards]

I been through the past-life thing with patients too Nick. What's even more frustrating than this kind of explanation though is when whatever is done in response actually "works".

[bernard]

Hi all,

The meme is based upon some robust affirmations:

• We live but when we die the soul remains alive.
• Our body is made with atoms that exist since several milliard years and they'll continue to exist after the death of the body.
• So I will be alive in a next generation. If this statement is true then I may conclude that the inverse is true.

[Nick]

It's not so much that I have a problem with a patient's beliefs. I can, of course, accept that even if I don't agree with it. I've learned that it's sometimes better just to let them believe what they want. What annoys me is that someone would use this kind of explanation in the context of physiotherapy to explain something that a little bit of study would allow them to understand easily.

I think this is why it is so important that people understand that neuroscience is not just another tool, but the shining light that allows us to understand everything we are doing in therapy. If it is just another tool, it is considered equivalent to all other explanations. The first premise is so important. Someone may have a coherent worldview that is consistent with their first, but incorrect or irrelevant, principle.

Thanks for your thoughts.

Nick

[Diane]

What annoys me is that someone would use this kind of explanation in the context of physiotherapy to explain something that a little bit of study would allow them to understand easily.

Yes, that is offensive, a PT suggesting anything like that to anyone in a patient context. Offensive to the profession itself.

[Barrett Dorko]

Therapists offering such explanations (and I use the term loosely here) are of two sorts; they actually believe what they're saying, or they know what they're saying can't be true.

Either way, the culture of therapy continuing ed, which is pretty much just a tea party, protects them from confrontation and consequent change.

[nari]

I reckon we are globally diverse enough in some ways, as a profession, to include those PTs who look for an interesting answer perhaps dragged out of a two day seminar. I don't have any further suggestions to this as I have never come across such a statement before within a PT context.

I have come across a few persistent pain patients who have stated that they must have done something wrong in the past to be punished like this. Also a few who have had an abusive childhood, and probably believe seriously that it will 'haunt' them forever in a somatic sense.

They responded to a brief explanation, to which the reply "well, it is a sort of memory, isn't it" was forthcoming. Fortunately, when the psychologist saw them, things improved on their front.

I haven't worked out yet what a still shoulder fracture is, so pardon my dimness, Nick.

Nari

[Bas Asselbergs]

Yes, I have heard from the PT involved in this yarn, that the patient travelled with the PT to Toronto. There they visited the "Past-life Regression therapist", where the pt was treated with CST releases by the PT while the 'therapist "talked her" through her past lives. The session was 3 hours, the cost was $400.00.
Her persistent thoracic pain - unresponsive to CST alone, or Cyriax manips or acupuncture or exercise - was found to be the result of a horse stepping on her chest....in the 16th century....
Her pain was gone after this session. This last little bit of "datum" was reported by the PT of the story, of course. I never found out whether the pain was gone forever, or whether there was any more treatment.

Why would anyone have trouble with this? It is abundantly clear that a) the pain MUST have come from this injury, b) there MUST be past lives involved in our suffering (how else can the past life issue help resolve the pain), c) it takes very profound specialisation to learn and treat this, so d) you MUST take these courses seriously.
I think these are excellent arguments to stay 'openminded". Don't be so ...well... cynical, folks.

[nari]

Fascinating. A 16th century horse...I wonder was she a brave warrior who fell off the horse?

I might take up Past Life Regression Therapy. Could find some interesting ancestors, if nothing else. Then they could haunt me.

Flippancy aside, it is disturbing that a PT was a back-up for this costly venture into the past.

Nari

[Barrett Dorko]

This story is truly unfair...to the horse.

Anybody willing to pay for it might deserve as much, though desperation always changes us.

Those who tell these stories are predators. Therapists often give them a humorous slant but they are far more tragic than anything else.

[Bas Asselbergs]

Yes, that's right Barrett.
It was told in 1993, with an excitement that was visually and clearly fed by glee: "I know something that you don't" and "Ain't I just the most sensitive one" - basically hiding his desperate need to believe in his own story and "skill".

He still practises, but I haven't heard a thing anymore about past-life regression from his patients. And I don't have contact with him.

There are still PTs working in our city with conceptual approaches of "energy cysts". "tilted sphenoids" or "blocked emotions". And the patients that keep coming back to these PTs, do so because they feel "understood by a specially gifted therapist, who thinks outside the box" (quote is from the spouse of one of those patients).

These PTs have created a pernicious meme that is now associated with MY profession.

[Karie]

I tend to agree with Bas; I don't have a "position" on the Past Life area but it is a strongly held belief system by many cultures and needs to be sensitively addressed if a patient brings it up. Just as it is not in our scope of practice to delve extensively into one's psyche, it is also not in our scope of practice to tell someone else that they are wrong in their spiritual belief systems. That is also crossing the line in my opinion. I also meet the person where they are at with respect to this and don't judge either way. I personally believe that their belief system continues the neurodynamic model because what they think is buried in that beautiful nervous system and is involved in the myriad of possibilities that those neural components can express themselves.
As far as being a predator, I can think of a number of chronic patients that if they could spend only $400 and get rid of their pain for good, they would jump at the chance. Ever look at how much these people have already spent before we see them in the so called respectful "medical model."
If belief systems didn't play a role in health, we wouldn't need a medical speciality that treats psychological impact on disease etc.

Karie

[Jon Newman]

Hi Karie,

You comments..

I don't have a "position" on the Past Life area but it is a strongly held belief system by many cultures and needs to be sensitively addressed if a patient brings it up. Just as it is not in our scope of practice to delve extensively into one's psyche, it is also not in our scope of practice to tell someone else that they are wrong in their spiritual belief systems.

..got me thinking. How does one determine if someone's belief system is strongly held?

Also, I think there is a difference between a patient having a belief system that guides their behavior and a therapist having a belief system that guides their behavior to point of it influencing their practice and what they tell their patients--for instance, suggesting to patients that they have past lives.

What if it the patient's belief system seems to be, at least partly, hindering progress. For example, "I should not do any physical activity which (might) make my pain worse"?

[Karie]

Hi Jon,

It is interesting stuff Jon, I agree.

I was speaking with reference to "spiritually held belief systems." Yes, I agree a PT shouldn't be the first to bring up the past life idea. If my patient brings it up and it is important to them in their therapy care then I will address it in their terms, not mine.

Activity levels certainly are within our scope of practice. If someone firmly believes that doing more will hurt them and your plan of care has determined that that is indeed needed, then you maybe need a behavioral health assist. It is their scope of practice to delve into why this is such a firmly held belief and if it is a problem for their health. Together you might be able to help the patient past the impasse. Don't forget there are many consciousness levels of beliefs that the patient may be utilizing to hold onto the pain. That's where behavioral health has been particularly useful when treating chronic pain patients. In my opinion you have hit a firmly held belief pattern if it is difficult to change, especially if it hinders their health outcome in the case of PT. Of course, a belief pattern may be a positive thing like, no matter how hard it gets I will work through and achieve my goals." Of course, positive and negative is in the eye of the beholder.

I believe we work with all kinds of belief systems everyday when we work with our patients and thats something that make us more unique as PT's. We actually see people and work with them long enough to know they have a belief system...LOL

PT's in general are pretty sensitive people who don't usually, in my opinion, go around purposely trying to impose their belief's on their patients. But on a bad day, as apparently Nick had, we aren't as neutral as we strive to be in our opinions. We all have our buttons!

Karie

[Diane]

I would deal with a topic like this by pointing to the diagram I usually draw for patients of "how pain works", a really bad sketch of a neuromatrix model combined with a gingerbread type human shape, with a brain and spinal cord, a nociceptor, how it hooks up, how ascending and descending modulation happens. There's always a spot somewhere near the top on the input side, for a category called "beliefs/emotions/thoughts/personal history".

Rather than let such a notion take over the entire session/therapeutic container if it came up, I would point to that category while saying yes, it belongs right here in this spot, meanwhile, this is what's going on in the entire nervous system. By the way, speaking of past lives, did you realize we still have a fish brain? Thus would we get the session back on track.

It really doesn't have to do with opinions or if they are right or wrong or if we should share them or pander to them or counter them, it has to do with education from a knowledge base, which is precisely where we should operate from, as precisely as we can.

[Karie]

Well said Diane !!

Speaking of horses, I am off to the Midwest Horsefair for the weekend with my daughter. I'll make sure I avoid them stepping on my chest.....LOL

Karie

[Jon Newman]

I do want to tread cautiously here as the title of the thread is "crazy deep models" versus, "simply mistaken deep models" and it is the latter that I think we most commonly encounter in the clinic.

I still have the question of how one determines if a belief is strongly held without any sort of attempt to interrogate reality.

I've never had anyone bring up past lives in therapy care. Is this common? Karie, can you clarify how you address their spiritual beliefs in "their terms."

I once had an inpatient (not even possibly an Offspring fan) that felt that the more she suffered, the more god loved her. This seemed to manifest in declining pain meds as well as not getting out of bed (after a total knee replacement.) I contacted our spiritual service folks to help her find a better metaphor. She did much better after that. I'm unsure of whether it was because of that or not.

Is there room in PT/patient education for the discussion of the supernatural? Does that have something to do with what we're treating?

[Nick]

I want to clarify a few things here. First of all, my problem was not at all with the patient's beliefs, but with the physical therapist who provided the explanation. How are we supposed to establish a science-based profession if this is acceptable?

Sorry for the confusion Nari. It should have read "stiff shoulder post-fracture."

People are certainly entitled to their beliefs, but this therapist imposed her beliefs on a client in a supposedly therapeutic context with reasoning that is nothing short of preposterous: "your shoulder is stiff because there is something you are holding on to from a past life." People do get desperate when they hurt and therapists get desperate when they don't get results or don't understand something. We, as a profession, can do better.

I think I am usually pretty sensitive to others and meet them where they are. I usually only lose my temper when someone asks if I'm doing reiki.

Nick

[Nick]

Actually Karie, it wasn't such a bad day at all. And I don't think being neutral in my opinions is what I am striving for.

Karie said, "Don't forget there are many consciousness levels of beliefs that the patient may be utilizing to hold onto the pain."

Can you explain what you mean by this?

Nick

[Jon Newman]

Hi Nick,

I want to clarify a few things here.

I think your thread was aptly titled with respect to your example and you ask a good question

How are we supposed to establish a science-based profession if this is acceptable?

[nari]

Nick, I was concerned by the PT/s going along with crazy deep models; not the patient's beliefs.
We all believe weird things, privately or publicly, and couldn't get along without those perceptions. It is quite something else to professionally endorse weird beliefs in patients. I figured that was what you said at the outset; and all one could do as a health professional is not endorse patients' beliefs, but not necessarily demolish them entirely.

When it comes to colleagues' endorsement of such notions....well, we can be either honest or dishonest in our practice, and a desire to do anything to help a patient is screwy.
PTs need to sort themselves out first as to their codes of practices. Even sharmans have their codes.

Nari

[Jon Newman]

Oh, there's just one more thing....I think there is a difference between having a spiritual practice and having a supernatural practice. My opinion is that there is no room for the latter but there is plenty of room for the former. "Therapy" involving past lives belongs squarely in the "supernatural" category.

I'm still interested in how Karie deals with this when the patient suddenly brings it up from no where like Nick's patient did. Nick, how do you think you would have handled it differently? Not having been in that situation, I'm pondering what I'd do. My interaction with the "more I suffer" patient was easy enough since we have a spiritual services department but I don't know what I would have done exactly had I been in an outpatient setting. I suppose I would try to come up with a more helpful metaphor myself but I'm not confident I'd have an effective response.

[Nick]

Barrett does a nice job on his course discussing origin and causation. The search for a cause is a dead end. I would simply refer to the reasons why people hurt and the appropriate response. I would also gently point out how an "alternative" viewpoint could lead to maladaptive coping.

[Jon Newman]

Hi Nick,

Barrett's essay Lost might be helpful also. I find myself saying something along the lines of "How you got lost in the woods is not nearly so interesting at this point as how you might get out or what you may be doing to keep yourself there", something I picked up from participating on discussion boards and I'm confident the source was Barrett. Or perhaps it was his course.

I can imagine that being helpful in the "past lives" and "the more I suffer" situations also.

[Karie]

Hi all I'm back from the Horse Fair and I see some people have some questions for me.

Interesting I was reading "The Sensitive Nervous System," by David Butler in between this weekend, in particular Chapter 2, and was thinking how this chapter nicely describes in the Neuromatrix model of how a patient's belief systems or basically how one interacts with their environment from their perspective contributes to the way pain is directed in the nervous system. So in answer to the question about how different consciousness levels (which is thought form conscious, subconcious, etc) can have an effect on how the body manages pain I would refer you to that Chapter. One of many potential examples of how pain can let's say subsciously be held onto is that important relationships in the person's life may be intrinsically related to the pain issue. If the pain goes away the relationship dynamic may change and that unknown may be more frightening to the individual then dealing with the pain, which is something they know, even if they don't like it. This is stuff that usually comes out in behavioral health type sessions, but you were asking for an example, so this would be one.
Nick you said it wasn't a bad day, maybe a bad session was more accurate. I was taking that thought from your third paragraph in your first post. (I would have done the highlighting thing but I don't seem to get the go advanced option after I click on the post reply, I am not very computer techno) You mentioned not being able to muster your usual restraint, distaste was also used. You also said something about the patient recoiling from what you said. So to me that doesn't sound like you were able to do that patient/therapist connection like one normally tries to do. So if I mistook you, sorry! That's what I thought you were saying.

I also get that your upset with the therapist, but isn't that who you should be directing your "distaste" too, not the patient. It sounded like in discussing your "distaste" for what the therapist did or didn't do you kinda made the patient feel like they were a bad person for listening to it. Again just my take on how you described things in that 3rd paragraph.

As far Jon as how I would handle a patient that brings it up I would first ascertain how important it is to what their goals are in PT and if it even needs to be addressed further than their casual mention of it during the evaluation. If it important I wouldn't talk about in regards to it being truth or not truth because as this patient stated, it hasn't been proven scientifically either way. Jon it is a spiritual not supernatural concept. There are many religions that believe in reincarnation. Maybe you haven't happened upon a patient from these religions but I have and to dismiss their belief as wrong isn't for me to decide. In the case of the therapist described in this thread I would not make an opinion about how they handled this patient because I wasn't there and I try not to devalue my colleagues in front of a patient. If I have a problem with that person there are other ways to deal with it. But back to how I would handle this person's concept would be much like a story. How does this information relate to what's happening with your pain? Does it help you to understand it this way to meet your goals. If so, then it's there understanding and then I move into what we are going to do to meet those goals with my PT plan of care. Using the concept described earlier it doesn't matter where the pain came from it's where do we go from here in the present time, moment etc.
I guess you could say I have, and I have to believe all of you to a certain extent have as well, heard all sorts of causations for pain described from patients. It's as Diane said, don't get caught up in the why, just move on to the plan of care.

Peace,
Karie

[Jon Newman]

If it important I wouldn't talk about in regards to it being truth or not truth because as this patient stated, it hasn't been proven scientifically either way. Jon it is a spiritual not supernatural concept. There are many religions that believe in reincarnation. Maybe you haven't happened upon a patient from these religions but I have and to dismiss their belief as wrong isn't for me to decide.

Hi Karie,

I work in a hospital founded on supernatural beliefs and it doesn't impact what happens in PT. I live in an area where the vast majority of people I see have supernatural beliefs and yet it almost never seems to come up in terms of their presence in PT or their goals. I don't' think I'm unique in this experience either. I don't try to dissuade patients of those beliefs but I don't try to specifically endorse those beliefs either. What I do try to do is explain their pain in terms of a biopsychosocial model to the extent that it seems relevant.

[nari]

I agree that there is quite a difference between a supernatural and a spiritual practice. An Irish PT I knew used to give talks about spirituality; what I devised from them was that spirituality was pretty synonymous with caring about the person, not just the condition.

If the patient was religious, it was accepting that a religion was important to them, in the same way friends and kin were important. Not deferring to the religion, but to its importance to the person. At the same time, many see the terms as synonymous.

A supernatural concept is one which I referred to back at post 32131. It is believing that 13 is an evil number, or black cats are evil, or whatever. Weird things which aren't related to a sense of spirituality, but more to a culture of fear provocation.

So the crazy deep model, as expressed earlier in the thread, smacks of supernaturality to me. The brain will check out a previously dysfunctional area at a time of stress and decide whether to turn on the pain output tap, but I don't think it applies in the situation as described by Nick. People will turn to anything that crops up to find a reason for pain/dysfunction, and if all else fails, recall previous physical or emotional trauma in order to link with causation.

Mostly, it's a lost cause.

Nari

[Jon Newman]

I re-read this thread for some insights. I think these thoughts

So, I’d conclude that an effective diagnostician turns the patient’s story into narrative and then repeats it back to them in a fashion that satisfies the needs of everyone involved – not always an easy thing to do – and the therapist needs to do this at the proper moment and at the proper pace as well.--Barrett Dorko

are the crux of this issue. Repeating the narrative back to the patient can indeed be quite difficult. In fact, I may actually suck at this. The scope of what gets repeated back is something I'll need to reflect on.

[Karie]

Jon I think maybe you need to define "supernatural."
I live in Wisconsin too and I can't say I know of any hospital that has supernatural concepts in it's mission statement. There are religious affiliations such as Catholic and Methodist, etc., so you have me quite perplexed by that statement. I also take exception to you stating that I "endorse" anything. As Nari stated, it's about it being important to the patient and I don't have a right to negate that and I need to be aware of it's function in that person's pyschi and resultant behavioral response connections. Do you not have a question(s) in your intake at your hospital that asks if there are any religious affliations or issues that would impact on the treatment protocols that may herein be set for you (patient) in treatment? It is a standard intake question at every medical facility I have been a patient of or an employee at for at least 15 years. This means that as the provider you are obligated to be aware of anything they might put down and address it in the plan of care. If such a question exists, someone, somewhere must have thought the person's spiritual affiliations, thoughts, however you want to term them has an impact on their treatment. Just because you have never had it come up, don't jump to the conclusion that I am that therapist that promotes it in my practice. I take "extreme" exception to that if that is indeed what you are inferring. And NO, I'm not saying they answer the question with my pain comes from a past life experience. I'm giving a premise to where someone thought spiritual concepts/religion has a place in understanding a patient's rights and it is "standard" protocol to be asked and appropriately addressed.

Biopsychosocial has psycho and social in it's name. I believe religious/spiritual concepts are under the heading of psycho/social, at least that is what I learned in school and see referenced in material I read today.

I'm not sure Nari if we are on the same page or not, but if it is important to the patient, whether it be past lives or a child with a terminal illness happening to this patient, it's a factor in how they approach their plan of care.

Just because we are uncomfortable with the topic doesn't give us the right to tell the patient their crazy. That's for the specialist in behavioral health to decide, not in my scope of practice.

For the record Jon, in 26 years of practice, it's come up about 6 or 7x that I can remember. Not that high of a number when I think of the number of patients that I have treated over the years. The first time I heard it I started researching more about the concept and how the various religions that have it in their doctrine view it. They all have a different viewpoint on how it all works, so there is not even agreement among the religions that address it. But I was open at least to learning and understanding it so that when it comes up, I know more about where my patient is coming from in that psycho/social concept. I do that with other areas that may include things like what they do for a living, sometimes I've never heard of the occupation or a business and I take time to learn about it.

END OF STORY!

[Bas Asselbergs]

In my opinion, and from what the PT in my story told me, this was NOT patient driven. And what I know of a few PTs in my town here, they do drive the sessions in that "type" of direction - subtly but they do it. Much as many other PTs tend to mold their sessions to their "style" (non-consciously or not). Even if one is quietly observing or listening, we are influencing the session. We need to be constantly aware of this.

There are many ways of acknowledging a patient's spiritual belief - but it is absolutely bogus AS A PT to engage in therapy based on nothing but a belief/spiritual idea. I have had patients tell me "you must vibrate on the same universal frequency as I am when you touch me - it releases my spirit" Am I going to charge them piles of money for "vibrating"?

I am convinced that the therapist in question LED the patient to this path.
And THAT is not professional within physiotherapy.

[Barrett Dorko]

Religion itself, any religion, is to some extent an acceptance of that which is supernatural, which simply means that there is no known natural explanation for what you're describing or "believe" in.

This isn't necessarily a bad thing by any means, and for many it provides great comfort and structure and sense of community. When applied to the explanations that ideally guide actual practice in therapy there are obvious problems however.

The therapist in question in Nick's first post is proselytizing. This means "to convert or attempt to convert; recruit." I suppose I try to do this when I teach, but I stick with what what I understand and can support within the medical and scientific model. It's easy to cross the line into what one "believes" and the culture we live in gives religious conviction a free pass when it comes to anyone else's objection or disagreement.

I wrote of this in What Went Wrong? years ago. I think it fits perfectly here.

[Jon Newman]

Hi Karie,

My apologies for writing in a manner that sounded accusatory. You clearly stated that you don't have a position on past lives and it's great you can remain so neutral. I was curious how you addressed it in "their terms" while not simultaneously endorsing those beliefs. Not that it can't be done. As I've stated, I haven't really considered it and only recently had a patient that brought her supernatural (as opposed to something like fear avoidance) beliefs up as a barrier to her progress. At that time I confessed that I was unable to help her in that regard beyond contacting someone who could. As I stated in my last post, what gets repeated back to the patient after I listen to their story is something I'll need to reflect on further.

Jon I think maybe you need to define "supernatural."
I live in Wisconsin too and I can't say I know of any hospital that has supernatural concepts in it's mission statement.

Supernatural

Hospitals based on religious ideals have supernatural beliefs at their core; it's what makes them religious. Here are our my hospital's Mission and Values.

Mission and Values Statement

Mission
Our Mission as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well being of all people, especially the poor, in the communities we serve.
Vision
Ministry Health Care is a values-based health care delivery system which, through its exceptional employees and physicians, provides compassionate, quality and cost effective services which focus on the mind, body and spirit.
Values
Faithful to the Values of our Founding Sisters, which guide our actions:
We provide holistic SERVICE that meets people's needs while considering the good of society.We involve people in decisions that are important to them.
Our Christian beliefs shape our VISION OF SOCIAL RESPONSIBILITY.We enable risk-taking and reward creativity that improves people's quality of life.
Wherever we are, our PRESENCE is marked by compassion, integrity, collaboration and accountability.We set future directions that assure the dignity and development of people above all else.
We stand with the poor.JUSTICE calls us to confront conditions of oppression and to help change structures that violate people's dignity.

For the most part, I really like them. There are some things I disagree with but unless you own your own business you're likely to find some disagreeable things anywhere. And even if you own your own business you have to interact with those in your community that may require you behave a certain way if you are to survive as a business.


Regardless, none of this seems to impact what I do in my job description. Performing vasectomies, abortions, etc. are areas that have been impacted however. I do think there is a difference between a patient not accepting a treatment based on supernatural beliefs and a health care provider using them to influence the treatment they are giving/offering patients. If it is the latter case I would hope that those beliefs are clearly announced someplace. My hospital for example does that. Here's another.

For the record Jon, in 26 years of practice, it's come up about 6 or 7x that I can remember.

I was wondering how often this occurred as it does seem to be very infrequent in my practice too. As Bas noted, I think there may be PT practices that somehow invite treatment to head in that direction, knowingly or not.

[Karie]

Thanks Jon, I appreciate your last comments!

I believe we just have a difference in viewpoint on what is supernatural and what is spiritual. I personally equate spiritual with one's religion. Spiritual to me is what the person themselves view as their beliefs in how life works so to speak. Supernatural to me is something that I can't explain in my own spiritual terms or scientific terms. I reference what "I think" because that is my filter of the world and Barrett's reference above that starts with a poem I like as well because that is exactly the point. Our patient has a filter of how they view the world and we do; and yes then there is this postmodern view going on that Barrett describes which I totally agree with.
I agree Bas there are some therapist's out there that point patients in those directions, I have seen it in the many classes I have attended in CST. Actually the instructors don't promote this nor did we as TA's, I actually got on my soapbox many times with students and said that you can't do that. Whatever the person is experiencing on the table, it is theirs, not yours. I have actually told people in talks that I have given that if anyone says I do SER (SomatoEmotional Release) to run as fast as they can away from this person. If a person has an emotional happening on the table, it comes from within themselves, we don't promote it. It's not the usual norm in Physical Therapy for these things to happen. So I do get what your saying BAS and I totally agree with all of you that it is inappropriate at the very least to subject our patients to how a therapist might think the world works spiritually.
Barrett, yes we are in that post modern soup of thoughts and Diane has pulled me up for air at times when I sunk too far and for that I will be forever grateful. Of course that gets into my spirtual belief that when the student is ready a teacher comes, in this case the teacher I needed was Diane.

Peace
Karie

[Jon Newman]

Hi Karie,

I believe we just have a difference in viewpoint on what is supernatural and what is spiritual.

I think you're right. To my mind, spirituality is a felt sense and does not require one to invoke supernatural explanation. For example, if two people are looking at an act of kindness being performed or a beautiful natural scene, I think both can have the same felt sense of interconnectedness, awe, humbling, and other emotions typically associated with "spirituality". If afterwards they were asked to explain what they saw I think it is completely reasonable that one may subscribe to supernatural explanations while the other may not. Both, however, had a felt sense that could be described as spiritual. In other words, I don't think that it is the supernatural that makes something spiritual. However, something that is spiritual can certainly encompass supernatural phenomena and typically does.

[Diane]

Karie, SS exists so we can all help each other, but at the same time no one can help anyone/teach anything to them unless/until they are ready to be helped/taught. So, congratulations on how well your self-teaching is coming along.

About religion etc....
I don't think about it much, but awhile ago I caught this interview on TV, and it was great. Stephen Jones survived the Jonestown massacre instigated by his own dad, the Koolaid guy. He was an older teen at the time, and happened to be away from the compound playing soccer that day. There were a handful of other survivors who were also away on business of this sort or that. Everyone who was home that day died.

He said something that burned its way into my brain (which may have been his own thought or a borrowed thought; in any case I'd never heard it before): He said, "Religion is for people who are afraid of hell; spirituality is for those who have already experienced it."
Nice contradistinction, I thought.

About hospitals, I found the Catholic one that I had some training time in (by comparison to the secular ones) well run, the people who worked in it generally more upbeat and well behaved, less egoistic. I noted that the administrator, a nun, did patient rounds as part of her duties. She didn't stop for long, just breezed around, nodded and smiled at people mostly, but she wore her administrator name tag so every patient would know who she was. I thought this was an absolutely charming idea, that personal ministration (ordinary humble nun behavior) was an excellent strategy for an administrator who was also a nun to keep, that it would maintain an extra inhibitory feedback loop. One suspected the staff behaved better as a result - they saw her in direct communication with patients and had added incentive to care well for the patients to avoid becoming a discussion point.

About supernatural, it's a BC tourism angle. Otherwise, my information sources suggest that there's no such thing.