Myofascial Release expert, author, and Physical Therapist John Barnes frequently says during seminars, “We never force, we never injure.” In my last blog, “WHY IT’S NOT OK TO FORCE THE FASCIA” I focused on the physical reasons for not forcing the fascia. To bring awareness to the emotional and mental reasons for not forcing, we the therapists must be fully present, while working with patients. Let’s explore the trust building foundation between patient and therapist. Both the patient and the therapist have an expectation about how the therapy will be, and what they would like as a result. But are they on the same page? Is there mutual respect and trust? Let’s discover what it takes to build this trust.
Why does someone trust their therapist? In my experience as a Physical Therapist for over 2 decades, there are several tools that I have found to be helpful. Initially, I introduce myself to them while looking into their eyes with a smile. Then, I ask them a little about themselves, remembering I will be spending a lot of time with this person. Next, I tell them a little about myself. It doesn’t take long to find a common thread. After assessing the injury or trauma that brought them to therapy, I validate their experience. This is the most crucial tool to building trust with a patient. Many times they have been to physicians, or therapists and their personal experience has been minimized. Some have been told they will have to live with this condition for the rest of their lives, and they become frightened and confused.
Continuing to build trust, I always explain what I am about to do to them and why. This makes them feel safe. I let them know that they can always refuse a particular treatment, but I also inform them of the benefits, and how it will help them obtain their goals. I encourage them along the way. I cheer, root for, and give them permission to heal themselves. A reminder of their progress with regular measurements really helps. Sometimes all they need to know is that it is possible to return to a pain-free active lifestyle. With so much ‘masking of symptoms’ going on as a social norm, and pharmacy companies blasting our minds with ads for their own padded pockets, no wonder our patients’ think they are stuck for life, with a condition. The last trust building tool I use is honoring their requests. If a patient tells me something hurts, I listen. If they say, “It scares me when it cracks like that,” (referring to a joint noise) I reassure them and educate them. If they ask me to ease up on an MFR (myofascial release) hold, or PROM (passive range of motion) to a joint, I do. The patient is always in control and safe. We are in a dance, sometimes I lead, and sometimes they lead. We work together.
So what does it mean to force the fascia or the therapy session, with my intention? It means I come into the session with a preconceived idea of what should happen in therapy today. I want to fix the patient. I have assumed a position of authority or superiority over the patient. Notice “I”. Not being in a ‘team work’ mentality, I have taken responsibility for their pain and medical condition. I will not be going home with them, so why would I assume that position? This is where many young, and to be frank, prideful therapists, find themselves. They are caught in a ‘fix-it’ mentality with an agenda, they are attached to a specific outcome. While patting yourself on the back for a job well done is not wrong, putting this first place is. The place to be, is with the patient working together while participating in a therapeutic dance.
During the dance of treatment, John often says, “If you feel like you are working too hard, you are working too hard.” I love that! Initially, when I started taking Myofascial Release Seminars from John, I thought he only meant “physically working to hard.” Now, as I am further along with this MFR journey, I have come to realize that it also means “mentally working too hard” with my intention. If I am attached to an outcome, I am in a sense, trying to force something to happen in a treatment session that may or may not be ready to shift. I am trying to take control of the fascia, the session, the condition, and the person. I have assumed responsibility for their pain and dysfunction. What actually happens is I put up an expectation, the patient feels this, and if they are not in co-alignment or working with me on this same intention, then by nature they are resisting it.
Carl Jung says, “What you resist, persists.”
As humans we resist what we feel is unsafe, intrusive, misunderstood, or not cohesive with our personal resonance and outlook on life. So we won’t be getting very far in therapy if that occurs.
Another form of resistance that must be considered, is emotional resistance. I have found that there are times when I have compassion on my patients for the condition they are in, and sometimes I have found that it is pity. Pity is feeling sorry for someone in a way that can cause regret or even contempt. It is a form of disrespect. It comes from a place of superiority just like the ‘fix it’ mentality. I am looking down on you with pity, “you poor thing”. Emotionally speaking, I am neither respecting you, nor honoring you! Compassion grows from a place of love. It stems from the root words ‘co-passion’, or ‘suffer with’ and brings with it the desire to work with someone to see them through a specific task. Working together we can reach much higher peaks than working alone or by resisting one another.
Observe yourself without judgement the next time you are treating a patient. Are you physically forcing, working hard with your hands, and tiring out your muscles? Are you mentally forcing with your intention and energetic attachments to a specific outcome? Are you emotionally disrespecting your dance partner with pity? John F. Barnes says frequently, “Without awareness, there is no choice.” Be present and aware of where you are in the dance, and then choose the position of CO-Worker, CO-Passion, CO-Laborer. Work with, not against each other, and the results will naturally manifest and leave both therapist and patient feeling well.
Trust the dance!
Looking for a Therapist who honors you and give you the individualized treatment you desire? Find a local John F. Barnes Myofascial Release Approach® trained therapist near you: