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Speaking the Language of Recovery

Speaking the Language of Physical Therapy
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Added on November 30, 2016
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By Alex Bendersky/Director – IvyRehab Highland Park, IL

I was motivated to write this article because of how little we understand about how nonclinical interaction with the patient influences the clinical process. There are two topics I would like to discuss; the use of language as a threat and the use of humor as an ally in the rehabilitative process. So, in summary, on the topic of how language can hurt and humor can help.

Let's start by addressing the language with use in the clinical setting, the use of anatomical and clinical references, the use of metaphors, the use of pictures and models that in great detail discuss and illustrate the menace that lives within us and how the use of clinical magic will eradicate this beast and bring us back to health. Language, words, terminology, anatomical models, wall charts, posters and lastly Dr. Google has progressively raised the level of anxiety and catastrophization in our patients. We are, in part, responsible for the failed medical model that caters to the pain community. Language can be a damaging, threatening and harmful instrument that leads our patients to enter a passive pain belief model. These passive pain beliefs allow us to venture on the endless journey looking for non existent cure for a non curable problem. Now, I know my position on this matter will raise controversy and opposition, but rest assured, there is a fix. To the right is the list of neurotags classically called danger in me (DIMs) and safety in me (SIMs) according to NOI group headed by Lorimer Moseley and company.

By controlling the perspective and allowing the language to express, measure and empower an individual we can change the internal monologue and the narrative of the personal struggle with pain and disability. Just as the use of harsh language can cause harm in ones recovery, the use of supportive and "open" language can inspire the patient, reduce anxiety and refocus patient on their rehabilitative path. Let's not focus on what is wrong with the patient, the details of the disease process and the anatomical and clinical shortcomings. Let's instead look into what drives and motivates the patient and ask ourselves what the ingredients are that will aid the patient on the path to recovery. Let us be the drivers in the recovery process, the advocates for patient's needs and the instruments in the clinical improvement.

Now a little bit on the topic of humor as medicine and the use of humor to enhance the clinical effectiveness of pharmacotherapy. This is an excerpt from the Journal of Oncology:

With solid evidence and support from literature, humor should be used to bring humanity to the "dry" clinical experience of everyday care. Humor and laughter can and should be used as a complement to traditional care. It can reduce anxiety and enhance clinical communication between the patient and the therapist.

In summary, let's focus on the language we use to conduct clinical care. Work on reducing the "threat" of the anatomical language and allow the barriers of communication to be broken by introducing humor into the clinical conversation.

Reference

What does the language we use about arthritis mean to people who have osteoarthritis? A qualitative study. Karen L Baker, Margaret Reid, Catherine J. Mimms Lowe. Disability and Rehabilitation Volume 36, 2014Linguistic positivity in historical texts reflects dynamic environmental and psychological factors. Rumen Iliev, Joe Hoover, Morteza Dehghani, and Robert Axelrod. PNAS 2016 : 1612058113v1-201612058.

Laughter: the best medicine? Oncologist. 2005;10:651Y60. Penson RT, Partridge RA, Rudd P, et al.

Therapuetic Value of Laughter in Medicine: Alternative Therapies. 2010. Ramon Mora Ripol, et al.


 

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