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  • #16
    Mr Dorko,

    I also can appreciate what you are saying but it is a tough road when the patient is that sick and that it falls on the practitioner to change. It seems pretty disempowering and can be seen somewhat as a paternalistic approach in which the practitioner has to come down to the level of the patient to initiate healing. It gets even tougher when addressing the factors affecting the patient’s ability to communicate might fall outside of the scope of physical therapy. Biopsychosocial approach is necessary in physical therapy but I believe in some instances that other health care professionals are better equipped and that referral is warranted (with an interdisciplinary approach to treatment if appropriate).
    I am not pretending to have the solution to solve these patients’ difficult problems (I don’t think any group does). I am just pointing out that it might set the wrong tone to start interacting with the patient in an “unequal” manner.

    My ideas are as elastic as my brain so I greatly appreciate criticism

    Victor Prati, PT

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    • #17
      Not critical, just talking about my current situation.

      Where do you work?
      Barrett L. Dorko

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      • #18
        I am not trying to be critical toward you either. If anything critical toward the way I practice. I am just wondering about better solutions and opportunities to empower the patient.

        I am currently working in Cape Cod as a travel therapist in an outpatient setting.


        Victor Prati, PT
        Last edited by ahboncainri; 13-02-2011, 12:31 AM.

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        • #19
          I really like this thread. I completely agree that umwelt is essential to a good therapeutic relationship. Anybody can lay their hands on a client or bark orders at them about number of reps and sets; but empowering the client requires that you've made that connection with them (entered their bubble, or as I prefer two bubbles becoming one for that period of time).

          There's another thread about the parasympathetic activity being the default state of the nervous system. I tend to agree, and think that sympathetics need to be settled down as part of the process of desensitizing the nervous system.

          Those without a passionate and honest voice or hands will not get past the sympathetic responses of "fight/flight" or "faint/play dead", however those with the umwelt will better be able to activate the "reset button" of the nervous system to restore the default parasympathetic state.

          Comment


          • #20
            More about umwelt, from Andrian Kreye answering Edge.org's question for 2012.

            Don't get your

            1. umwelt ("subjective environment as perceived and impacted by an organism"... aka first-person, aka "effective","efferent") confused with your

            2. umfeld ("objective environment which encompasses and impacts all organisms in it's realm"...aka, third-person, aka "affective", "afferent").


            A good example from the next two contributors, Hazel Rose Markus and Alana Conner, about expectations, stereotypes.
            Last edited by Diane; 15-01-2012, 06:31 PM.
            Diane
            www.dermoneuromodulation.com
            SensibleSolutionsPhysiotherapy
            HumanAntiGravitySuit blog
            Neurotonics PT Teamblog
            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
            Canadian Physiotherapy Association Pain Science Division Facebook page
            @PainPhysiosCan
            WCPT PhysiotherapyPainNetwork on Facebook
            @WCPTPTPN
            Neuroscience and Pain Science for Manual PTs Facebook page

            @dfjpt
            SomaSimple on Facebook
            @somasimple

            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

            Comment


            • #21
              Wow this thread is sooo cool. I have been using the analogy of something similar with pain. In order to enter a space of collaboration, akin to entering the umwelt together. I speak of pain as a metaphor that subjectively decreases the amount of movement we are willing, or feel we are able to complete. Or in other words, lets say we could represent the total amount of movement available to an individual as a bubble. Often time pain naturally constricts the size or shape of that metaphorical bubble. Therefore and in part to restore the natural homeostatic relationship of movement and pain we have to figure out where the boundaries of the bubble are. Then once we have established that do we begin to tease, tug and push those boundaries gently. The theory goes that if we continually push this bubble gently we will "stretch the limits" and the body will begin to interpret the previously painful movements as normal. This is very similar I believe in scope and philosophy to Cory's edgework.

              I have found good success with explaining pain this way because it is often how patients feel. It empowers them in a collaborative way with the therapist and we begin to explore together.

              Very cool stuff. Thanks Barrett.

              Eric
              --------------------------------------------------------------
              Body is imbued with mind, and mind is embodied.

              Comment


              • #22
                It is cool. I almost remember beginning this thing.

                Seriously, the book about the Amur tiger (see post #1) has come up in conversation twice this week.

                I have some strange conversations.
                Barrett L. Dorko

                Comment


                • #23
                  I wrote a long rambly all over the place blogpost about this, earlier today: Bio and psycho and social embraidedness
                  Diane
                  www.dermoneuromodulation.com
                  SensibleSolutionsPhysiotherapy
                  HumanAntiGravitySuit blog
                  Neurotonics PT Teamblog
                  Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                  Canadian Physiotherapy Association Pain Science Division Facebook page
                  @PainPhysiosCan
                  WCPT PhysiotherapyPainNetwork on Facebook
                  @WCPTPTPN
                  Neuroscience and Pain Science for Manual PTs Facebook page

                  @dfjpt
                  SomaSimple on Facebook
                  @somasimple

                  "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                  “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                  “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                  "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                  "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                  Comment


                  • #24
                    just discovered this thread via Barrett flagging it up on noi jam …umwelt …great discussion here and there . You anticipated things a bit earlier Barrett ! Thanks . Its got so many applications in terms of ones current state of activity level and the environment one interacts with/in ...

                    Comment


                    • #25
                      The chameleon is another good analogy.
                      Remember, it's PUNday Monday...
                      Attached Files

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                      • #26
                        Being as opposed to Doing. Being with them instead of aimless chit chat, saying those oft trotted out phrases "how are you" and doing to them.

                        If you wish to see/sense their current state and wish to enable a fair state then being not doing would be the way forward.

                        Oh and one of my favourite words is german "Waldeinsamkeit" came up in a play I saw, a play for children which brings back to the kindergarten teacher, the play told a story and did not do it in a special way for them. Children and some adults are acutely aware of the authentic.

                        Brings me to acting, maybe the best actors, the most convincing ones are not acting but actually become the character - still thinking that one through.......
                        Last edited by chrislowndes; 10-06-2014, 05:45 PM.
                        Chris Lowndes
                        http://thinkingmoving.me

                        Comment


                        • #27
                          Waldeinsamkeit: the feeling of being alone in the woods.

                          Exactly. Perfect. (That's the feeling I have always had, right inside my own profession!)
                          It's the human condition - all the trappings of society are there to try to dispel it, create an illusion of human troop.
                          Diane
                          www.dermoneuromodulation.com
                          SensibleSolutionsPhysiotherapy
                          HumanAntiGravitySuit blog
                          Neurotonics PT Teamblog
                          Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                          Canadian Physiotherapy Association Pain Science Division Facebook page
                          @PainPhysiosCan
                          WCPT PhysiotherapyPainNetwork on Facebook
                          @WCPTPTPN
                          Neuroscience and Pain Science for Manual PTs Facebook page

                          @dfjpt
                          SomaSimple on Facebook
                          @somasimple

                          "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                          “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                          “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                          "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                          "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                          Comment


                          • #28
                            Yes being alone in a roomful of people. Some persons pretend to be part of the troop, others think they are part of the troop and others feel outside (Waldeinsamkeit)......

                            Modern society with its large loose groups "friends" (see Facebook) may make this feeling more prevalent. http://www.theguardian.com/technolog...a-robin-dunbar
                            Chris Lowndes
                            http://thinkingmoving.me

                            Comment


                            • #29
                              Chris says:

                              ...actually become the character...
                              This is a large part of The Method.

                              I've heard stories about how intense that can be.
                              Barrett L. Dorko

                              Comment


                              • #30
                                Well, Waldeinsamkeit, Mary Oliver even wrote about it.

                                “How I go to the woods

                                Ordinarily, I go to the woods alone, with not a single
                                friend, for they are all smilers and talkers and therefore
                                unsuitable.

                                I don’t really want to be witnessed talking to the catbirds
                                or hugging the old black oak tree. I have my way of
                                praying, as you no doubt have yours.

                                Besides, when I am alone I can become invisible. I can sit
                                on the top of a dune as motionless as an uprise of weeds,
                                until the foxes run by unconcerned. I can hear the almost
                                unhearable sound of the roses singing.

                                If you have ever gone to the woods with me, I must love
                                you very much.”
                                He, he.
                                Carol Lynn Chevrier LMT
                                " The truth is, people may see things differently. But they don't really want to. '' Don Draper.

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