The Therapist becomes the Client


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Having been a swimmer most of my life, it was no surprise that I injured myself while transitioning from a low-impact sport to a high-impact one. Within weeks of taking up running, I began to feel a sharp pain in my right heel. The sensible thing to do at that point was to stop, rest, and seek medical advice.

I kept running.

Standing at the top of the normal curve, I tend to look to my right (your left?) at the people above the Average. I doubt that the above Average person would have stopped running because of pain. In fact, the above Average person would probably not be injured in the first place because he has good running technique and luxurious barefoot shoes. In any case, not running because of pain is not consistent with my “pain is weakness leaving the body” motto. It would also not serve to burn the calories from the daily butter tarts I devour. I kept running until I was limping my way around campus.

It took months before the “call physio” item made it to the top of my to-do list. Before the appointment, I did what any graduate student would do: I collected data. I charted the location, intensity, and quality of the pain on a daily basis in an excel spreadsheet. I Googled “heel pain” and diagnosed myself with plantar fasciitis. I also took four Advil’s a day and kept running.

The physiotherapist asked me if I was comfortable with having a second year student do the examination.

What do you mean a student? Does she know what she’s doing?

That was a hypocritical reaction. I am student therapist myself! I report to a registered psychologist, and a supervisor approves all of my decisions.

“So the pain is your right heel”, she asked with a shaky voice, gripping her pen and clipboard to her chest.

I was compelled to be the best patient this young physiotherapist to would ever have. I immediately told the student physiotherapist (SP) that I had plantar fasciitis. I regurgitated the symptoms off the websites, and asked for shockwave therapy.

At that moment, I heard the physiotherapist’s eyes roll in their sockets.

In a clinical setting, there are few things more frustrating than a client who tells you what to do. There is a clear difference between “This is distressing, what can we do about it?” and “This hurts and I need you to do this for it to stop”. The first expresses the desire to work collaboratively, the second is an order.

From my perspective, I was trying to be efficient and helpful. Instead, I was ruining an opportunity for the SP to learn and coming forward as a bossy hypochondriac.

The SP began the examination by evaluating my foot’s range of motion. Her fingertips barely touched my foot, as if she was afraid to break it. She looked back at her supervisor for reassurance between every exercise and question.

I couldn’t help but sympathize. Assessment and questioning is challenging: you have to formulate an open-ended non-threatening question, evaluate the response, interpret it, note it down, and think of the follow up question simultaneously. All the while, you have to look like you know what you are doing.

Meanwhile, I asked questions about every instrument and exercise. From my perspective, I was being curious, from hers, I was annoying.

Eventually, I was dismissed with a plantar fasciitis diagnosis (Should I say I told you so?), a prescription for a therapeutic sock, and stretching exercises. As I walked out of the office, I realized how uncomfortable the role-reversal was for me.

Therapists and health care professional make difficult clients: we don’t seek help when needed, we don’t follow instructions because we think we know better, we over-research, and tend to be skeptical . I think we compensate for our paranoia and fear of looking weak by trying to show off how ‘knowledgeable’ we are about our ‘condition’. We simultaneously try to save the health professional work and appear confident, but in the end we make the assessment and treatment more complicated.

What if I had walked into the office and expressed more vulnerability? Maybe for once, I should have indulged in someone’s curiosity. I wonder what I was running from.

What type of patient are you?

Averagely yours,
The Candidate

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2 thoughts on “The Therapist becomes the Client

  1. What a nice blog entry! Very refreshing 🙂 Here’s something I’d like to share!

    As an osteo student I am very curious about the physical body. And I often book appointments with all kinds of specialists to explore different therapeutic approach. In my earlier treatments, I’ve probable came accross as ”annoying” because I asked too many questions. I wanted to know everything or show that I knew this or that technique. Maybe it was intellectual curiosity at it’s best. Maybe I was just struggling with my insecurities regarding my newly chosen vocation.

    Over time, I’ve learned more from these specialists when I told them simply that I was a student (and didn’t specify what in, not until they asked eventually). Maybe they didn’t start by sizing me up and categorizing me in their ”osteo student” box, or even worst, their ”annoying osteo student” box. Our therapist-patient relationship started as one, instead of some other hierarchical or competition relationship. And the learning opportunities came when I interiorized the technique, taking in the experience and feeling what each technique did to my body and mindset. Questions came after.

    Asking questions after the treatment will show the therapist you paid attention and are interested in their profession. And it will get them talking much more!

    • Thank you for your input Angèle. I think that telling the therapist that you are student in (mental/physical) health can improve the relationship and even the care you receive. The therapist might feel comfortable giving you more detailed information and you can be more involved it the treatment. Unless the therapist is grumpy, is having a bad day, or doesn’t like his/her job, why wouldn’t they want to tell you more about their work and techniques? I love to engage my clients in the treatment as much as possible.

      I think the issue arises when the client tells the health professional what to do! That’s what I did when I went to see the physiotherapist – I gave an order!
      Also, at the physiotherapists’ office, I asked many questions to a student, who might have been very nervous about giving me the treatment in the first place. Looking back, I might have made the situation more stressful for her!

      R – the candidate

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