Exploring outside the box.
Written by Kit Wisdom of Wise Physiotherapy. Repost with permission.
The nuanced weaving of physiotherapy and positive psychology. An experience of experiential learning.
I remember when I really hit the wall. I had hit it a few times previously, but maybe those times were more sort of slight scrapes; bumps that didn't quite stop me from soldiering on. Bruises that could quickly appear superficially better. This time though, I stopped. Sat still. Really appraised my situation.
Single mum. Toddler in tow. Family living on the other side of the country. Working as a physiotherapist in a large private sports-oriented clinic. Just shy of ten years of service. 15 years all up. Really needed my job to survive; financially, emotionally, mentally. And yet I felt completely boxed in.
I struggled to know what I needed because I felt like I couldn't make much of a change. I wanted to learn, use my brain, but none of the physiotherapy continuing education courses blew my hair back - they actually did the opposite. I felt a sense of dread thinking "is this is what further learning looks like?" More biomechanics, more specific diagnoses through a dysfunction tickbox process, more putting people in body part boxes, more calculated knowing, more looking for pain-blame, more fixing. More mechanistic tendencies; less and less humanness.
I had reached the outskirts of my box. It was feeling too small, too limiting, uninspiring, somewhat meaningless. It was starting to feel claustrophobic and murky. I remember feeling so in need of a change that I considered leaving the physiotherapy profession. And yet, when I returned to my life context, where would I go?
During one of my psychology sessions, I was introduced to the world of positive psychology - well, introduced in an explicit way. My psychologist had been employing a positive psychology approach with me the whole time ... I just had no idea what that really was. And so, right on cue, she nonchalantly suggested I have a squiz at a masters that looked to intentionally apply the principles of positive psychology throughout other professional contexts.
I had a look. My heart rate, which normally sits at 42 beats per minute, felt like it rose over 100. My laptop screen was asking me (no, the screen wasn't talking to me) if I was interested in being part of a world-renowned program at Melbourne University that intentionally created professional intersections to foster positive, meaningful change.
At that moment, I was in. (I still had to get past that entrance essay thingy having not written an essay since year 12 English ... but besides that old chestnut (!), this felt just like what I needed.) I could feel the lid of my box opening slightly, loosening its hold; letting in some air and light.
However, I also remember feeling a heavy sense of conflict, that by even considering a Masters in Applied Positive Psychology as my next professional learning step, I was somehow cheating on my physiotherapy family.
That might sound kinda hectic to you, but I am all about acknowledging feelings. I have learned that they can be such important pieces of information.
For me, they are guideposts that are telling me something, and I need to sit still with them, to better understand what the hell they are trying to say.
Ok, so back to me feeling like I was double-crossing my family. To me, this speaks to my health practitioner conditioning around the question, "who knows best?". Throughout a lot of my career, I feel that question was typically answered with, "physio people know best about bodies". (Hola reader, feel free to interchange 'physio' with whatever field you come from, because, don't we all do this in a way?)
As we have evolved in our understanding of human existence in the past 20 years, we have discovered that our brains and our emotions impact our behaviour more than we might have thought. This is really important for our physical health world as it means we cannot solely rely on biomechanical information to help the people in our care.
However, where do we go to explore this new understanding?
For me, to embark on a Masters that had 'not much' to do with the physiotherapy world and felt somewhat left-field, I noticed a strong sense of separation pervading my insides.
What was this separation feeling telling me, do you reckon?
(I'll leave a space for your thoughts, here ... feel free to have a ponder)
When I sat still with that feeling, it gently talked to me about what my future could look like and feel like. It spoke to my want to integrate; to interweave; to collaborate; to cooperate; to look outside ourselves for different conversations; to assume we do not know all; to see other bodies of knowledge as compatriots - to see their purveyors of ideas as comrades, as champions of future connections.
In a roundabout way, the discussion I had with my feeling (yep, that's what I just wrote) gave me permission to feel 'nexcited'. Nexcited is a word my kid and I made up that so that 'nervous' and 'excited' can share a common, collaborative space. Potentially I use it more than him. Because I feel he knows himself more than I ever did at the tender age of 7.
I felt nervous to be 'leaving' the safe confines of a structured, dominant medical-model approach, yet also excited around my choice to leap into a learning pit like none other I had ever experienced.
Lets recap. I'm a physio, 15 years into the making. I take what feels like a decent-sized masters step into the land of the unknown, whilst fully acknowledging my inner nexcited conflict. (I also make up words to describe my inner landscape).
For those curious humans in the room, positive psychology might need an explanation. It can sometimes be taken as 'happy-ology' due to its title - yet this was chosen more to create space for its intentions as a field.
Rather than only studying what goes wrong with people, a bunch of curious researching psychologists wanted to see what they could glean from looking outside of the psychology box, and consider what went well with people.
And so positive psychology was born, as the scientific study of positive human functioning and flourishing. It sprouted off from stock standard psychology to empirically study well-being, and as such, more focus was put on the 'positive' side of life. As the field matured, constantly learning from its scientific process, 'second-wave positive psychology', or PP2.0 evolved.
This second wave promoted a more nuanced exploration of well-being, looking towards the totality of the human condition to inform our knowing. A major theme studied empirically explores growth through adversity. This, to me, is where the resonance shines with the world of physiotherapy.
Pain is suffering. Injury and dysfunction challenge our well-being and our ability to thrive. Persistent pain can be a hard, gritty, quite often shitty landscape to experience. Yet as physiotherapists, we are not properly prepared to deal with such realities; we grow up groomed to fix people, to be the hero, to win. What if winning has nothing to do with it at all?
What if the need to win is distracting, detracting, demoralizing us from the actual purpose of our profession?
If someone held me hostage and said: "you have to describe your well-being masters experience in one word - no random blogs allowed!" I would first say, well, foof off! Only one?! ... and then I would *probably* choose the word relationships.
Relationships: the way in which two or more people or things are connected, or the state of being connected
Throughout the masters, we learned about connection, interconnection, relatedness, relevance, collaboration, integration, intersections, - of people: yes, of me to myself: definitely, of me to others: yep - yet also of concepts, theories, constructs, fields of expertise, bodies of knowledge, of ways to present information. Ways to think and learn and, in essence 'know'. Where knowing is more about not knowing.
I was exposed to an environment that gave me permission to observe, play, explore, and reflect on all the relationships I came into contact with - no matter how abstract or ambiguous. I also learned - quite emphatically - that relationships are the glue that holds us together. They are central to sustainable well-being.
(It also taught me to put commas in certain places and order my thoughts in a structured way ... that falls under the somewhat tense relationship between me and academia ...)
Humility.
This would be the next word I would choose to describe my well-being masters experience (ok ok, if I was allowed more than one word ... rolled eye emoticon .. one, as a number, is kinda isolating anyway - everyone needs a buddy - connection is key, right?).
Humility to me, speaks to believing we can always learn from others.
In our physiotherapy field, I feel this has been both easy and tricky.
Easy in that we have had leading physiotherapists - amazing researching brains and creative clinical brains - bringing us along on the knowledge journey, constantly helping us figure out what we know as less wrong. That is the beauty of the scientific method - iterative in nature, constantly updating, leaving us little time nor room to get comfy in the 'latest information'. Its whole process is a method to learn, to fail, to be curious, to stay critical in our thinking.
However, tricky in that we have taken a while to intentionally look outside our physio-selves for help. Help in better understanding the people we want to help.
Tricky in that we have historically been seen as the 'body experts' - so to look towards our patients for help, could feel like somewhat of a failure on our behalf; to look towards other professions for help; that do not specialize in the human body and specialize more in the brain or in art or in history or in culture or in teaching (you get my drift?), could leave us feeling like our specialty was not so special anymore. De-specialized. Potentially even minimized, or left out.
This is where my masters experience was so rich and thick in learning. We came from all different backgrounds - teaching, healthcare, business, IT, coaching, academia, psychology, organizations - our commonality was not in which 'tribe' we represented .. but rather in our 'why'. We came to learn from other people's applications, other people's experiences, other people's specialities, other people's fails, other people's wins. Others. As others have such different and powerful ways of seeing the same world.
I experienced a way of learning that was in complete contrast to my undergraduate degree. I had lecturers whose intention was to develop my critical thinking and engage in robust discussion, rather than advance an agenda or 'tell' me what was 'right'. I heard more "I don't know's" from a leading well-being 'expert' in one discussion than I did in my whole undergraduate degree.
This allowed me to reflect on why I had originally questioned the way I had learned in the physiotherapy domain.
It was not that I was rejecting the evidence-based knowledge platform from which so many interesting concepts and practical applications arose, it was the lack of looking outside the box.
And by looking, I mean openly curious, not defensively guarded.
By looking, I mean wholly acknowledging no one person, no one profession actually 'knows it all'.
By looking, I mean truly understanding we are all meaningfully enriched through deeply listening to the experiences of others.
If we are all indeed interconnected, all part of the same world story, then staying in the box seems futile.
How can we learn to know more together?
Science allows us to be less wrong. It allows us to develop more of an understanding of the factors at play. It does not tell us what is 'right', however it does provide a process by which we can learn.
This is what was so cool about weaving the world of positive psychology (and beyond) with physiotherapy. They both use science to further develop knowledge from which we can help the people who need our care. And at the same time, they are both more consistently acknowledging the limitations of how the 'evidence' plays into each individual patient's care.
And with this acknowledgment comes the realisation that whilst science can seem so helpful for explanations, it cannot answer everything. Science can explain what we are, yet struggles to explain who or why we are. This is where lived experience can give us richer insight than science ever can.
To be honest, it feels like we are all hanging out in a huge playground called the world. And we are playing in parallel. Not interested in the notion that there are different ways to play. Not acknowledging that playing with others is how we learn. Can you remember one of those moments from childhood? Or shit, as an adult. You're in the playground, and you can see a whole bunch of 'others' in the same playground, playing too. You want to play with the others and ask them what they're doing - it looks cool and fun and different - but you don't know how to stop doing what you're doing, how to break the ice, how to look over, how to smile, how to say hi, how to ask "what are you guys up to - it looks interesting - can I join in?"
To me, it requires being vulnerable. To be that kid again. To have your heart in your mouth as you explore the new uncertain terrain. Isn't that what uncertainty is all about? Trusting in its inherent value, its worth; whilst at the same time, understanding the emotional risk involved in letting go of certainty.
And yet that then begs the ultimate question - is anything in life truly certain?
Do we, as professions, as practitioners, as 'tribes' - need to let go of the illusion of control?
If we continue to choose our certainty boxes over putting ourselves out there in a way that feels scary yet necessary, are we not missing out on vital opportunities - not only to collaborate, play, and learn - but to grow as wholehearted humans in a constantly evolving playground?
It feels like the way forward demands the certainty of uncertainty, whilst holding that worldview as a choice we get to choose. As individuals, and just as importantly, as professions.
We gotta get out of our boxes, team.
Thank you for your words Kit - The Physio Social Club.
To learn more about Kit’s approach to Physio check out her website.