I ate the marshmallow: Lessons in impulsivity.

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I ate the marshmallow: Lessons in impulsivity.

It was a simple experiment that changed the way psychologists understands self-control and the ability to delay gratification. Preschoolers were asked to sit at a table, with a plate of marshmallows. The experimenter left the room and gave the child an important choice: eat the marshmallow right away or wait until the experimenter returned and have two marshmallows instead.

Have one marshmallow now, or wait and have two marshmallows.

Some children ate the marshmallow. Other children stared at the sweets intensively and reminded themselves that it’s better to have two later than one now. They covered their eyes, looked away from the marshmallow, or even pretended to eat it, licking their lips from its imagined deliciousness. Yet they resisted temptation and delayed gratification for a better outcome in the future.

eat me.

eat me.

I would have eaten the marshmallow – no doubt. As soon as the door clicked closed, and the experimenter was out of sight, I would have told myself something along the lines of “Just wait. You can do this…. just – ohhh…that was delicious!”

End of experiment.

To clinical psychologists (or to-be-ones like me), self-control is essential. We have to inhibit our judgment, advices, and responses, and allow the client to lead the session. Delaying such reactions can be challenging for someone like me (i.e., impulsive and extroverted).

Inhibiting social responses is difficult. I want to jump with excitement when a client has done their homework and gasp when I hear sad news. Although these reactions may be appropriate between friends (although I don’t know why I would congratulate my friends for doing their assignments), positive feedback in a therapeutic setting be should attuned to the client’s mood and personality.

I notice improvement, I jump on it.

I hear change, I highlight it.

I see a marshmallow, I eat it.

Withholding advice is also challenging. Lawyers and doctors have it easy. Lawyers are (over?)paid to tell you what to do in order to get the best outcome and doctors write it out on a prescription pad. Whether or not you choose to follow their advice is your business. Psychologists on the other hand are taught to guide clients through their own recovery. Success is defined by the client, not the therapist. This is a challenging and time consuming process that requires – you guessed it – self-control. It would be too easy (and ineffective) to tell my client how to think, behave, and feel. In my work with offenders I have found myself sitting on my hands, biting my lips, while containing the urge to stand up and yell “THEN JUST STOP BREAKING THE LAW!” Thankfully I have managed to curb that urge so far.

I like to think of my impulsive nature as a reflection of my genuine interest in the client’s experience. Once in a while, my spontaneity fits the situation and engages the client. Particularly with children – they light up when you show excitement and interest. Perhaps there is such a thing as planned impulsivity: an oxymoron describing a therapist’s ability to assess whether it is best to be restrained and matter-a-fact or be more spontaneous and direct.

Averagely yours,

the candidate
Impulsive

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The Tough Mudder Trilogy: The Path of Ignorance

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Last weekend I completed the Tough Mudder challenge: a 16km obstacle course inspired by the British Special Forces training protocol, which takes place mostly in – you guessed it – mud. I blindly signed up for the race after a friend’s recommendation, much like I decide to pick up broccoli at the grocery store because a friend forwarded a broccoli and cheese soup recipe to me. “Sure – I’ll do it”. The recipe never made it from my inbox onto my dining table. Tough Mudder on the other hand, left bruises and scratches.

There are multiple analogies I can draw between an obstacle course and graduate school or my work as a clinical psychologist (in training), and I will explore them through a trilogy of posts.

The first analogy is obvious. I was well aware that graduate school and Tough Mudder would be challenging (read: exhausting) and scary (read: terrifying). Despite the blood (don’t underestimate paper cuts), sweat, and tears that I expected from graduate school and Tough Mudder, I signed up for both.

sure, I’ll do it

The Path of Ignorance

Arrive in Barrie Ontario – check-in at the hotel.

There were five us: Rob, the Tough Mudder veteran, who spoke about the endless hills, treacherous roads, and painful obstacles the way university professors discuss their research: confidently disregarding the audience’s angst and ignorance of the topic.

There were Rachel and Brooke, two sisters who had done similar races and athletic training in the past. I did not know what to expect from them, but knew one thing: neither would be wearing hearing aids during the race, meaning that they could not hear anything. No cheering, no booing, no “get out of the way because this 200 pound man is about to fall on top of you”. Communication with them would be with eye or tactile contact.

Finally, there was Megan, the back-to-back-group-exercise-classes-at-the-gym friend who gently coerced me into signing up for Tough Mudder. Megan spent hours – nay days – researching the Tough Mudder obstacles and learning how to mentally and physically prepare for the event. She was the equivalent of the person who compulsively examines the statistics regarding funding applications for graduate students, and who constantly reminds you the odds and timelines. From time to time, a video illustrating a Tough Mudder challenge found its way into my email inbox. I reluctantly clicked on the link, watched the first five seconds where a camera lens is splattered with mud with rock music in the background, then stopped it. I chose ignorance.

In fact, I steered clear from any sort of information before the race. Conversely from my “day job” as a graduate student and clinical psychologist, where I am required to understand my clients and their mental illness from every angle, I chose not to delve into the ins and outs of the Tough Mudder challenges. I chose ignorance over the knowledge of how and when I will be injured or terrified (read: die).  I rather prance through the event blindly and cope with its challenges as they arose. After all, the focus of my doctoral research is the treatment of anxiety– what is a better place to put my “expert” knowledge to good use than an event where my mental stamina will be tested?

awkward silence

This is as good a time as any for me to tell you that I am not a dare-devil. I am a nervous wreck who is susceptible to peer pressure. That is a dangerous combination.  I was not the child who jumped from the rooftop into the pool or who tried to do a cart-wheel on a balance beam. Roller coasters were the highest ranking item on my “extreme activity” list, until I somehow agreed to skydive five years ago. I am the child who wore a helmet and who ducked down every time the ball steered into her direction at dodge ball. Lifeguards never warned me about running on the side of the pool:  I was age-inappropriately alert about the possibility of slipping and breaking my front teeth. The fear of losing my front teeth is also the reason why I do not know how to ice skate. Shameful for a Canadian, I know.

At dinner on the night before the Tough Mudder race, my teammates further dissected the obstacles. Every other sentence began with some variation of “I’m really worried about _______”. The blank was filled in with terms such as “Arctic Enema”, a challenge where contestants jump shoulder deep into freezing water and swim under a barricade, or “Everest”, where contestants run up a quarter-pipe and pull themselves to the other side. My chest was pounding and I was short of breath. I felt as if I accidentally walked into a seminar about structural equation modeling: embarrassingly confused and terrified.

As I gorged down my pasta meal, in the midst of nearby conversations and the hockey game playing the back ground, I heard the following combination of words:

Electric.

Shock.

Water.

I looked up at Rachel and my eyes requested that she repeat her statement. What Rachel was describing was the “Electric Eel”, a challenge where contestants crawl in water, with electrical wires hanging overhead. In short: you crawl in water while being shocked. I paid to do this. I paid to squirm through water while being electrocuted. I held back tears while Rob attempted to minimize the potential damage of the event, much like my supervisor would try to convince me that presenting at a conference is no big deal.  Megan attempted to mitigate my anxiety by reminding me that Arctic Enema would be much worse. Thanks Megan.

My teammates’ general response to my panicked state was “relaaaaaxxxx, you’ll be fiiiinnneee”. Telling an anxious person to “relax” is as effective as trying to explain to undergraduate students that the required readings for a course can be found in the course syllabus. Then trying to tell them where to find the syllabus…..and telling them what the “syllabus” is.

The same way I teach my anxious clients to relax, I took deep breaths and reminded myself that the likelihood of dying while crawling in water under electrical wires is slim. I took deep breaths and reminded myself that no amount of research could have prepared me for these challenges. I took more deep breaths and reminded myself that I paid for the event, drove over 5 hours to the site, and publicly announced my participation. I took deep breath and gobbled down more pasta.

Anxiety is the overestimation of danger and underestimation of coping abilities. In preparation for Tough Mudder, I chose ignorance to prevent exaggeration of threat. I chose ignorance so I wouldn’t be reminded of what I cannot do. However, 12 hours before the race, I was flooded with information I did not want. Most of that information was threatening and my brain refused to process any evidence of safety or ability to cope.

I wonder if the path of ignorance was the correct one to take.  Would I have been less anxious if I knew what was coming?

Would you rather know or be ignorant before an event like Tough Mudder?

Are you typically under-prepared or over-prepared? 

Averagely yours,

the candidate

Strong Spine, Humble Chin

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Strong Spine, Humble Chin

Humility is to make a right estimate of one’s self – Charles Spurgeon

A large part of my work as a (future) clinical psychologist is interviewing. Interviewing clients for the first few years of my clinical psychology degree was like entering a large crowded mall. There is information zipping from every direction and too many paths I could take to get to my destination. Although I had a road map with the basic information I should collect (confidentiality agreement, informed consent, medical history, academic background, family history, presenting problem…), I was easily distracted by minor off-topic comments (read: a sale at Banana Republic when I’m shopping for eyeliner). The result was a stilted interaction filled with “okay let’s go back to when you told me about…” and “we’ll come back to this in a minute”. I would step out of the interview confused, exhausted, and missing information.

In other words, my initial interviews were like making half a dozen detours on the way to the makeup counter.

Over time, I have less of what sports psychologists refer to as “cognitive anxiety”, or negatives beliefs and expectations about myself and my performance. For instance, I’m less likely to have thoughts like “I am going to screw this up”. This confidence comes with practice, preparation, and supervision. Over time, I’ve learned to flag items of interest without breaking the flow of the conversation. I learned that a nod or tilting my head to the side with eye contact can be as effective as a follow up question. I have more practice, more skills, and I am more confident.

In short, I know that Banana Republic will still be there once I pick up my eyeliner. Or that the eyeliner will still be there even if I stop by BR.

At least in sports psychology, anxiety and self-confidence independently impact performance: they are not opposite ends of the same spectrum. Self-confidence is the personal belief that one has the ability to complete a task (i.e. “I can do this!”). Intuitively, self-confidence has a positive impact on performance. Meaning that the more I believe I can do it, the better my performance will be (Many American Idol participants will relate to this finding). Cognitive anxiety on the other hand, has a negative relationship with performance.

Therefore, the better I feel about myself and my skills, the better my interview should be. The fewer negative beliefs I have about myself, then I the better I should perform.

Got it.

Not quite.

The incremental sense of assurance about my interviewing skills bit me in the ass when I chose to enter a feedback sessions (a concluding session with a client where the results of an assessment are discussed) without reviewing the history and main findings. I figured I would “wing it” since I had given feedback for a similar disorder before. Unfortunately, during the appointment I struggled to find my words, shuffled through the file and papers, and looked back at my supervisor one too many times to fill the awkward silences. I felt lost. As we left the interview room, he smiled and said “trouble finding your words today?”

No, my words weren’t lost; they were not prepared to begin with.

I once again struggled between confidence and complacency when I tried a new yoga studio. The typical yoga studio etiquette is that more advanced students set up at the front of room, to provide a visual cue for more novice students. Being a recently certified yoga teacher, I confidently unrolled my mat at the front of room thinking “I got this”. I stood tall, with my chin a little too high in confidence. Within 20 minutes of the class, I lost half of my body weight in sweat and wobbled on my feet between poses. My ego dripped from my forehead every time I turned in to a downward facing dog.

tree progress

Confidence (just like curiosity) can kill the cat*.

And the ego.

Confidence comes with practice, but maintaining humility as we develop our skills can be as challenging as the skill itself. Confidence can actually result in a weaker performance. When confidence increases, we are more likely to develop complacency, or self-contentment while being oblivious to limitations or dangers. Confident individuals are more likely to use short-cuts, put less effort in the task, and subsequently make mistakes.

In the interviewing situation, I felt confident because I had performed well in a similar task in the past, so I did not prepare as much. The result was a stilted, embarrassing, and confusing session for all parties involved. At the new yoga studio, I felt that my experience and new “status” would result in a better performance. I did not take into account the new challenges that each situation could present, and fell smack on the face – literally.

As some psychologists are discovering, a little bit of self-doubt can actually improve performance, shedding doubt on the previously held belief that confidence is key. Doubt keeps us alert and open to the possibility of failure and ensures that we monitor our actions.

I think the key lies in knowing that I have ability, while accepting that I do not know what can be thrown at me. Maybe confidence and humility are on a spectrum?

I now try to walk into every interview, therapy session, or yoga class with a strong spine – acknowledging the work I have done and things I know – and a humble chin: accepting that I have so much to learn.

Averagely yours,

the candidate

humility cartoon

*no cats were harmed in the writing of this post

Is this your first time?

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Is This your First Time?

Look at situations from all angles, and you will become more open

– my man DL (aka, Dalai Lama)

As I escorted my client and her mother to the door, it was obvious that she was taking longer than necessary to put on her jacket. Her child was jumping about, inspecting toys in the psychology clinic waiting room. I pretended to be busy: filling papers, closing books, doodling smiley faces on my clipboard.

“So is this your first time?”

Her voice broke through the thick atmosphere.

I looked up and shook my head “no” too fast for it to be natural: It was more as if I was trying to shake something off my head while over-blinking.

“I’ve sat in on assessments before”

“Right, but you’ve never actually done one have you?”

“We practice the tests before administering them, and all graduate students in clinical psychology are supervised by our clinic director.”

I felt like a novice tennis player playing against a tennis-ball machine on overdrive. She fired shots at me; I hit the ball back but it barely made it to the other side of the net.

“Well my child is a special case. You know that. It won’t be easy.”

She was now on expert mode. Our exchange went on for another minute-that-felt-like-an-hour or so, until I finally told the mother that her daughter was in good hands and I will see her next week.

The machine stopped, turned around, and rolled out of the office.

This happened three years ago, and the thought of that exchange makes my hands shake.

My initial reaction was anger. I “knew” that she wanted me to admit my novice status or acknowledge the difficulty of the case. Why wasn’t I able to admit that to her? To myself? Anger is a normal reaction when we feel that we have been treated unfairly…but she wasn’t unfair…was she?

Anger turned into confusion: why would she ask me these questions? Did I do something to exhume incompetence? Would she ask another student? Again, I looked at my behaviours, my thoughts, and myself as a clinical psychology student and assumed that she saw weakness and incapacity. I assumed that she was poking at my weak spots, scratching on my insecurity scabs, and waiting for blood.

lucy as psychologist

I finally applied one of the simplest but most effective cognitive behavioural therapy methods to myself. I asked myself what evidence I had that the mother was targeting me, or attempting to expose my weaknesses. As I tell my young clients, I played detective for my thoughts! My investigation looked a little something like this:

Evidence for the possibility that she is targeting me and attempting to expose my weaknesses

Evidence against the possibility that she is targeting me and attempting to expose my weaknesses

She asked questions about my experience. She talked about her child being a “special case”, not me being a poor clinician.

She asked about the services offered at the clinic.

She asked about the consequences of the findings.

She asked about timeline.

She did not ask to speak to my supervisor after each assessment (she could have).

She came back and her daughter completed the assessment.

Chances are this awkward tennis match was not about me at all.

It was maybe the mother’s insecurities regarding the assessment and its findings. What could we find out and what would that mean for her daughter?

Once I looked at the situation from a different perspective, I felt compassion for her. It can be difficult to have a loved one poked and probed to figure out “what’s wrong” with him or her.

On the other hand, I was biased in the way I heard the mother’s questions – I assumed they were about me, and that my abilities were being questioned (on some level, maybe my abilities were being questioned). That is a classic symptom of the imposter syndrome but also a very selfish way to think.

As a clinical psychologist in training, and hopefully a “full” psychologist someday, I have to accept that there will always be people who doubt my profession and my abilities.

What I learned from this experience is this:

  1. Not everything is about me (unacceptable!)
  2. Not everyone is out to get me (shocking!)
  3. The tools I use with my clients can work for me (imagine that, I am average!)
  4. Looking at a situation objectively can help me shift perspectives
  5. Taking a compassionate approach is soothing (My man DL says it best)

Averagely yours,

the candidate.

Layer Cake: The Anatomy of Graduate Student Cohorts

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Cohorts in Graduate school are like layers of a cake; nicely stacked at first, but eventually the filling sinks into the cake and it settles. If done right, every layer’s taste, texture, and colour complements the other.

The new Master’s students (MSc1) are the top layer of the cake: the icing. They are always neat and presentable for their new position. They are eager, anxious, and maybe most likely to experience the imposter syndrome. You will find them skipping through the halls with their hair dancing in the wind, optimistic at the thought of the knowledge they will acquire and generate in graduate school. On other occasions, you will find them nervously gathered in the hallway exchanging notes. The expectations and stressors of graduate school are made worst by the challenges of living in a new city and starting a new social life. The first year is a brouhaha of anxiety and excitement.

The MSc2’s are the layer under the icing. They are relieved that the first year is behind them and proud to be approaching the first significant milestone of their graduate career. For some, it is a turning point: do I keep going or stop?

PhD1s and PhD2 are sandwiched between the old and the new. It is a no-man’s-land between the novelty of a new phase and the trepidation of the road to come. Presentation takes a backseat since Graduate school has long lost its glimmer. Nevertheless, the excitement of having three new letters at the end of their name is enough to keep most of them going. PhD1 and PhD2s students have proved themselves by defending their thesis and their identity in terms of research and practice is taking shape. Either way, there is a short-lived sense of accomplishment, a night of irresponsible drinking and debauchery, and the inevitable return to a harsh reality.

Interactions with PhD1s and PhD2 should be undertaken at your own risk, as they are a volatile cohort. Like the middle layer of a cake, it is either the favorite flavor or the eccentric addition. Graduate students in the middle years are as stable as dynamite. They are confident and motivated in the morning but have a mental breakdown next to the coffee machine by lunch. Handle this cohort with care.

I am part of the last group: the seniors. PhD3+ students have jumped through countless hoops: Master’s defence, comprehensive exams, proposal, course work, yet they know there is more to come. It is too late to turn back, stop, or to second-guess decisions. Everything has become a checkmark on the road to graduation. Our motto: a good thesis is a finished thesis. For seniors, the excitement of a new cohort arriving has long subsided. Instead of looking forward to meeting the new faces, we wonder if the newbies will take our TAship slots.

layer cake

Like a good cake, the layers complement each other in graduate school. MSc1 students benefit from the guidance of every other layer. They remind us of how optimistic we were when we started this journey. The middle year students can be unpredictable, but they provide the necessary drama to mix.

In my opinion, PhD3+ students are mostly likely to crumble under the pressure. If left to our own devices, we would spend our time knitting, quilting, baking, and watching Downtown Abbey in bed with camomile tea. We PhD3+ students benefit from the energy and pristine motivation of the younger students. Do not give up on us!

After all, we are all sitting on the same plate, being eaten up by the same goal.

Averagely yours,

the candidate.

Progress

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Progress

If we are facing the right direction, all we have to do is keep on walking

Buddhist proverb

Martin Scorsese’s 2006 The Departed is one of the few movies I can quote word for word. Of course, my appreciation of the movie is unrelated to the fact that Matt Damon and Leonardo Dicaprio are lead actors (lie). My favorite scene from The Departed is actually in the ‘director’s deleted scenes’. It is a longer version of a scene that was kept in the movie. In the extended (deleted) scene, Captain George Ellerby (Alec Baldwin) questions Staff Sgt. Colin Sullivan (Matt Damon) about progress in trying to arrest Francis Costello (Jack Nicholson).

[please read with your best Boston accent]

 alec-baldwin-matt-damon-warner-bros-pictures-departed-970410291

Staff Sgt Colin  – So I’m not making enough progress with Costello?

Capt Ellerby – Progress is hardly defined. I make progress every day. In fact, I am making progress right now. There are guys in this department who make excellent progress for 20 years without ever getting anything you can definitely call “a result”. Who gives a mother’s fuck. It’s like any other American industry. Nobody minds if you don’t succeed so long as you don’t fuck up. Objectives get lost sight off. Fair enough.

I love this speech because it reflects an attitude towards life and work that is prominent in graduate school. As graduate students, we are on a long journey with an ultimate goal: the doctorate. From time to time, I stop and ask myself: what am I doing? How did I get it here? Where the hell am I going next? The scariest question of them all: who cares?

I then look up and realize I’m standing in line at Starbucks. I order my personal non-fat grande latte and move on.

Evolution-of-Resumes

I believe Captain Ellerby’s statement about progress can be applied to any endeavor  research, writing, clinical work, or another one of my passions: yoga. I will focus on clinical work, but these ideas can easily be applied to writing or yoga. Simply substitute ‘therapy’ for ‘research’ or ‘posture’ and substitute ‘clinician’ for ‘writer’ or ‘yogi’. The argument is the same.

Therapy [Writing/ Yoga] begins by identifying a goal: a destination. In therapy, goals might relate to change in thought patterns, behaviours, or interpersonal relationships. In writing, the goal may be to finish a psychological report or a research paper. In yoga, the goal may be to hold a posture with comfort and confidence.

Subsequent sessions are steps toward the goal or the destination. Every session is progress, movement towards the destination. However, as a clinician [writer, yogi] I may never see the result. The client can terminate therapy or I might have to leave and refer the client on. I might only see a fraction of the progress. Does that make my work less valuable – is progress enough, or is result necessary? Does the destination really matter?

Captain Ellerby seems to think that progress is enough: “There are guys in this department who make excellent progress for 20 years without ever getting anything you can definitely call “a result. Who gives a mother’s fuck.”

In some cases, progress is the result: change, as long as it is in the right direction, is result. For instance, I once had a chronically depressed client who hadn’t opened his mail in over a year. One of his treatment goals was to open his mail. By the end of five sessions, he had organized his mail, but not opened it. Was my work with him meaningless?

I don’t think so.

Movement, as long as it occurs is positive.

As a clinical psychologist in training [writer, yogi], I have to remember that every step towards the destination is valuable and should be highlighted. In therapy, highlighting progress is important for the client, so he or she remains engaged. It is also important for me as the clinician because observing and valuing progress keeps me engaged and gives me a sense of purpose. The steps and the incremental progress become a goal.

tree progress

Captain Ellerby’s statements also bring to light a potential pitfall of focusing on progress. His statements “Progress is hardly defined” and “Objectives get lost sight off” remind us that we should keep track of progress and not lose sight of an objective.

Again, this is true in research, writing, clinical work, and yoga. Highlighting progress presumes that it is measured and evaluated. Throughout therapy, I revisit the goals with the client, re-evaluate the process, and adjust expectations. By doing so, the goal, or the destination may change.

In writing, every draft of a document is progress. The end result can be different from the original idea.

In yoga, every mindful breath is progress. The experience of that breath can be surprising.

In order to survive this long journey, I remind myself of the importance of valuing every step along the journey. I accept that clients move at different paces. I accept that even after I work on a report for 8 hours, it may not be finished. I accept that paperwork, bureaucracy, revisions, and editing, are part of the writing process. I accept that the headstand is a challenging posture for me. 

I am slowly accepting the fact that I may not reach the destination I chose 5 years ago. This doesn’t mean that I won’t finish my PhD. It means that I may end up somewhere I didn’t expect to be. 

In the words of Captain Ellerby – who gives mother’s fuck?

What does progress mean to you?

Is progress insignificant without a result?

 

Averagely yours,
the candidate.

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