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  • #16
    Less blame on myself and less weigth on my shoulder was one of the greatest improvement in my professionnal life. So happy it came along with my shift in thinking 5-6 years ago. It was also a very humbling experience truly realizing I wasn't really fixing anyone with my hands as I was lead to think.

    Back in the days it was either blaming the pt for not doing the exercices or blaming the PT for not knowing how to find/treat whatever obscur dysfunctions. Or worst, feeling worthless because you can't seem to find a subtle mouvement restriction or tension in a tissu...

    God what a relief.
    Frédéric Wellens, pht
    «We often refuse to accept an idea merely because the tone of voice in which it has been expressed is unsympathetic to us.»
    «
    Those who cannot understand how to put their thoughts on ice should not enter into the heat of debate.
    »
    Friedrich Nietzsche
    www.physioaxis.ca
    chroniquesdedouleur blog

    Comment


    • #17
      What a great quote and a great thread.

      I still can't say that I have completely freed myself from blame when patient's don't improve, this is still something I struggle with every day - even knowing a fair amount about the complexity of pain I still think I set some unreasonable expectations for myself, and thus for my patients as well. I think part of me still has that mentality that I should be able to fix people, I guess it is more deeply engrained than I thought.

      I think addressing each and every patient with the intent of understanding their complaints rather than looking at the scenario as a problem that need to be fixed was a first step for me here. Also realizing that I am just setting one foot into the stream of the patient's neuromatrix for 30 minutes a couple times a week helps me respect my role in all of this.

      I guess what frustrates me most is all the patient blaming I hear. And it's always the same thing - "That work-comp is just malingering", or "She's an MVA, you know, one of THOSE." Everyone else is a "weenie" with "no pain tolerance" who probably isn't doing their exercises.
      As I struggle with blaming myself too much, many of my colleagues take the easy way out and completely blame the patient, relieving themselves of any responsibility. It is born of plain and simple ignorance. Unfortunately, ignorance is something I think CAN be blamed for the outcome of a clinical encounter.
      Ryan Appell DPT
      @Rappell_PT

      Comment


      • #18
        I teach a pediatrics course at the local PT school. Today we had a guest speaker who I was fortunate to see when he was preschool age. He is now 22 and training for the paralympics (in power lifting). He told his story to the students, and mentioned that he purposely quit any PT around 14 years of age out of rebellion, and because it was just not important to him. He had surgery at 17 years of age, and had a successful run of PT after that, because it helped him do something he wanted to do.
        One of the students asked what the PT could have done at 14 to make him want to continue therapy. He said "nothing", it was his decision, and it had to be important to him. He was in the midst of taking responsibility and control of his life. This led to a short, but beneficial discussion of how a PT can't "fix" things. I was thinking of this thread at the time. The students reactions were interesting. Some seemed relieved, some seemed puzzled. We had to end class because were we running late, but hopefully we can pick up on it next week!
        Not every jab needs to be answered with a haymaker. - Rod Henderson

        Comment


        • #19
          Originally posted by Jason Silvernail View Post
          We were taught in Fellowship to be "process focused" and not "outcome focused" and that's a distinction I found very helpful. Also reading The Enchiridion is recommended.
          It's interesting that the Enchiridion is very similar to the Dhammapada in discussing mindfulness of practice.

          Additionally the four noble truths teaches some valuable insights into pain science. It's crazy how much of what we are learning in neurosciences are in a sense validating the some of the central doctrines of Buddhism.

          Dukka: The truth of suffering (To live is to suffer)

          Samudaya: Truth of the Cause of Suffering (the cause of suffering is due to craving. I.e. constant input from your sensory)

          Nirodha: Truth of the End of Suffering (To limit suffering, is to limit your desires. I.e. pain can end)

          Magga: Truth of the Path (The 8 fold path there is a path that leads to end of suffering)

          The Path of Truth:
          -Right mind
          -Right understanding
          -Right speech
          -Right action
          -Right work
          -Right effort
          -Right mindfulness
          -Right concentration


          -jb

          Comment


          • #20
            Does anyone know where this quote originally appeared? I can find references to it, but not an original thread/post?

            Jason, do you remember where you first wrote this?
            Kyle Ridgeway, PT, DPT
            PT Think Tank |@Dr_Ridge_DPT | Google+
            "It takes a deep commitment to change and an even deeper commitment to grow." - Ralph Ellison

            Comment


            • #21
              jbizzle:
              I realize that Buddhism is considered a relatively "cool" religion in the current culture, but it's a religious belief system, nonetheless. For future reference, the forum has a policy on "persistent advocacy" of metaphysical or supernatural commentary:
              The discussions at SomaSimple cover a broad range of topics, which are explored to various depths of understanding. While SomaSimple recognizes that some members may have arrived at supernatural or metaphysical explanations that offer personally meaningful answers to the questions raised in these discussions we have decided to confine the content of discussions to naturalistic and sociological reasoning. The purpose of this policy is to avoid unconstructive disputes over religion and other personal belief systems. It is the position of SomaSimple that persistent advocacy of supernatural or metaphysical explanations in the discussion forums may result in censure. If you have any questions about this policy you are encouraged to contact any of the Arbiters (names appearing in light blue)
              John Ware, PT
              Fellow of the American Academy of Orthopedic Manual Physical Therapists
              "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
              “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
              be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

              Comment


              • #22
                "The cynical mind is the superior mind", from B. Russell a History of Western Philosophy. Russell is being sarcastic of course JBizzel.

                If that's Buddhism philosophy, it has serious flaws. It's too fatalistic and discounts pleasure in life.

                Comment


                • #23
                  Originally posted by John W View Post
                  jbizzle:
                  I realize that Buddhism is considered a relatively "cool" religion in the current culture, but it's a religious belief system, nonetheless. For future reference, the forum has a policy on "persistent advocacy" of metaphysical or supernatural commentary:
                  It didn’t seem to me that jbizzle was saying that Buddhism is “cool” or that he/she was “persistently advocating” for religion.

                  I'm far from an expert on Buddhism, but I agree with jbizzle that there seems to be a link between therapeutic neuroscience teachings and Buddhism teachings on pain. We shouldn't be afraid to point that out and that's not the same as preaching for religion.

                  This is one example:

                  "the cause of suffering lies not in events or circumstances, but in the way we perceive and interpret our experience as it unfolds" Yongey Mingyur Rinpoche
                  -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                  The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                  Comment


                  • jbizzle
                    jbizzle commented
                    Editing a comment
                    Sorry--- only 4 years late to the comments, but since was about a year from my first posting to about the first follow up comment-- But Evanthis is the winner of the chicken dinner in noticing the parallels in what is being taught in neuroscience vs Buddhism teaching. So perhaps, maybe, cognitive science is a much older treatment arm than any one of us can truely appreciate? The bigger question what direction are we headed in the future we can enhance and empower our patients?

                • #24
                  There are links between any major religion's treatment of pain and suffering and neuroscience. I could quote people like Aquinas, Thomas Merton, and Karen Armstrong all day long.

                  But that's not what we do here, thus the re-statement of the board policy.
                  John Ware, PT
                  Fellow of the American Academy of Orthopedic Manual Physical Therapists
                  "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                  “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                  be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                  Comment


                  • #25
                    Originally posted by John W View Post
                    There are links between any major religion's treatment of pain and suffering and neuroscience. I could quote people like Aquinas, Thomas Merton, and Karen Armstrong all day long.

                    That’s completely fair, but to my limited understanding neuroscience teachings are more in alignment with the central doctrines of Buddhism than those of other popular religions. Don’t hear me saying that Buddhism is superior from other religions. Why would you comment that Buddhism specifically is considered a “cool” religion? I think that's misrepresenting jbizzle point. You could have made a comment about religion in general. Nevertheless, IMO there can be debate about religious teachings and pain without religious propaganda.
                    Last edited by Evanthis Raftopoulos; 29-11-2014, 09:24 PM.
                    -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                    The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                    Comment


                    • #26
                      Some of the cognitive behavioural therapy techniques, like mindfulness, have been lifted from traditional Buddhism-associated meditation.
                      What's secular about it is that no spiritual ideas are primed into the minds of those learning the process. Jon Kabat Zin comes to mind. It's only about breathing and focusing on breathing. Period.

                      Again, we must separate out what's appropriate, useful, objectively applicable and of neurological benefit, from all the subjective ideation that is culturally or religiously specific and relative.
                      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


                      • #27
                        Originally posted by Diane View Post
                        It's only about breathing and focusing on breathing. Period.
                        It really depends on the person. I think it’s OK if one wishes to include in the paradigm within religious teachings along with neuroscience teachings, or at least spirituality which is not exactly the same as religion. I also think it’s OK to discuss about it in the context of open minded skepticism and as long as your are not trying to push your point of view on others. Francisco Varela had successfully done that a number of times.
                        -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                        The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                        Comment


                        • #28
                          Originally posted by Evanthis Raftopoulos View Post
                          It really depends on the person. I think it’s OK if one wishes to include in the paradigm within religious teachings along with neuroscience teachings, or at least spirituality which is not exactly the same as religion. I also think it’s OK to discuss about it in the context of open minded skepticism and as long as your are not trying to push your point of view on others. Francisco Varela had successfully done that a number of times.
                          I disagree.
                          I think it's wandering over a boundary to allow mysticism to enter treatment.
                          We're supposed to be a profession grounded in objective material reality (which includes brain and brain function).
                          Anything religious or spiritual is outside our scope.
                          Anything ideational that is not science-based is outside our scope.
                          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


                          • jbizzle
                            jbizzle commented
                            Editing a comment
                            @ Diane-- Where does "treatment" intent lie within the paradigm?

                            For the record-- I'm not necessarily advocating one particular religous denomination, however, I'm merely wondering about the mere differences in the "state" of our minds when we treat others... Perhaps mere placebo effect?

                        • #29
                          This is one good reason why we need to uphold professional boundaries and keep religion out.

                          If we default to allowing "spirituality" in, we might as well default to "energy" explanations for good results in the clinic, give up on battling woo.
                          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


                          • #30
                            It sounds that you missed my point. I was talking about one’s paradigm within and in the context of discussions such as this one, not about our scope of practice and teaching patients about pain. As mentioned, people are entitled to construct their point of view on spirituality but they are not entitled to push it on others.
                            -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                            The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                            Comment

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