I’m always on the hunt for new information on why physiotherapists should broaden their perspectives through 1) how we connect with people and 2) in what ways we connect with them.
Connectivity is an emerging concept in physiotherapy. Several papers have been published discussing and arguing the broader view of the connections people make between ‘one’s self and another (or others)’(Gibson, 2006), and how stigmatization and societal disability transcend what biomedicine can provide to the public (Gibson, 2006; D. Nicholls et al., 2016; D. A. Nicholls & Gibson, 2010).
Chronic pain in particular is one such problem that transcends biomedicine. Our bodies are ‘thought of something we have rather than what we are’ (Bullington, 2009) and biomedicine objectifies our body through its philosophical underpinning, reducing us into a ‘material, functioning system, consisting of muscles, bones and tissues, nerves and chemical substances’ (Bullington, 2009). For people in pain, that is to live in a painful world and so how they once lived in their world, is now radically altered. When we experience chronic pain, our attention is brought to the body part. Counter-intuitively we disconnect from the body part and often the world around it. We protect it, avoid moving it, limit our interaction of the outside world with it. Objectifying the body perpetuates this understanding of the body as being something we have and so chronic back pain is not necessarily something we want, but almost certainly something we have.
Back pain restricts every aspect of a person’s life, we know this from studies such as the Global Burden of Disease study (Vos, 2015) and whilst it may sound provocative to suggest that back pain is not something we have but it is something we are, when it comes to the multifactorial contributors of chronic back pain and disability this is certainly evident. This, of course, is representative of all chronic pain.
Perhaps connectivity is a way to reconceptualise the perspective. Connectivity embraces a continuum of communication and movement through interoception* at a molecular level (Chapman, Tuckett, & Song, 2008) through to how we connect with our outside world (Gibson, 2006; D. Nicholls et al., 2016). This might be with other people, animals, the environment, plants etc to show people with pain that there is a world outside of the pain-full world, and that it needs to be outside of our clinics and hospitals. Perhaps they require an agent to spark this process? How about physiotherapists?
So to finish off here’s a clip from the highlander movie, it’s cheesy and Sean Connery’s grunting is a bit odd but the clip shows Sean Connery teaching Christopher Lambert’s character about connecting with the deer to increase his own strength, agility and speed. Now whilst I would argue if this is even possible, perhaps it’s a metaphor for understanding what happens in our own body when we connect with the environment and connect with our bodies.
Thanks for having a read and watch.
*Interoception – the sense of what is going on inside your body.
Bullington, J. (2009). Embodiment and chronic pain: Implications for rehabilitation practice. Health Care Analysis, 17(2), 100–109. https://doi.org/10.1007/s10728-008-0109-5
Chapman, C. R., Tuckett, R. P., & Song, C. W. (2008). Pain and stress in a systems perspective: reciprocal neural, endocrine, and immune interactions. The Journal of Pain : Official Journal of the American Pain Society, 9(2), 122–45. https://doi.org/10.1016/j.jpain.2007.09.006
Gibson, B. E. (2006). Disability, connectivity and transgressing the autonomous body. Journal of Medical Humanities, 27(3), 187–196. https://doi.org/10.1007/s10912-006-9017-6
Nicholls, D. A., & Gibson, B. E. (2010). The body and physiotherapy. Physiotherapy Theory and Practice, 26(8), 497–509. https://doi.org/10.3109/09593981003710316
Nicholls, D., Atkinson, K., Bjorbækmo, W. S., Gibson, B. E., Latchem, J., Olesen, J., … Setchell, J. (2016). Connectivity: An emerging concept for physiotherapy practice. Physiotherapy Theory and Practice, 32(3), 159–170. https://doi.org/10.3109/09593985.2015.1137665
Vos, T. (2015). Global , regional , and national incidence , prevalence , and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries , 1990 – 2013 : a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386, 743–800. https://doi.org/10.1016/S0140-6736(15)60692-4