+ How to handle the, “What did you do to me?” question. – September 05
+ Comment from Mij Ferrett, craniosacral therapist
and editor of ‘The Fulcrum’, journal of The
Craniosacral Therapy Association of the UK. – September 05
Dear John,
I have been practicing for two years and am
enjoying the work immensely. By an large my
practice is going well.
Every now and then a particular kind of patient
will come back for their second visit and accuse
me of doing something to them.
Sometimes it is subtle, sometimes not so subtle.
They will say things like, ‘My neck was fine
before I came to see you for back pain.
Now it is really painful.’
I find it very hard to know what to say to them.
Any suggestions would be greatly appreciated.
NC
Eire(Ireland) but you knew that anyway.
>>>MY COMMENTS:
Yeah, I may live in Oz but I still know where
Ireland is.
Your question highlights one of the most
difficult aspects of natural medicine.
That people have been conditioned to be
irresponsible about their health.
‘Fix me Doc.’
When someone asks you ‘What have you done to me?’
they are relating to you like a doctor.
I don’t know whether you have thought about
this or not but, like it or not, you are a pioneer.
You are at the cutting edge of a fringe.
So one of your tasks must be education.
If you are able to tell you are dealing with
‘that kind of patient’, then you would be wise
to take some pre-emptive measures to avoid them
asking you the question in ADVANCE.
The best way to solve a problem being to
never have it in the first place.
Don’t know where I heard that but I love using it.
When you identify the person as being irresponsible
at the first session, you need to start explaining
to them right away how it all works. Focusing
particularly on how you are supporting their
body to fix itself.
That you are not trying to direct how that
process will go, because you know from experience
that peoples bodies know best how to fix themselves.
How sometimes things can get worse before they get
better.
Help them to discover how remarkable their body is.
Worst comes to worst and they come back the following
week and ask you what you did to them?
You can reframe it for them by reminding them
what you actually did. You laid you hands gently on
different parts of their body for varying amounts
of time.
You didn’t click them or manipulate them or adjust
them. In light of all that isn’t it an indication
of how powerful this way of working is, that it can
reach such depths in the persons body with such a
light touch. And how their body can respond in such
powerful ways to this kind of support.
Lastly, if you are getting that kind of feedback
a lot, you might need to look at yourself. Your
intention may be too strong. You may be trying
too hard. You may be too attached to what you
think is the right outcome.
Generally speaking any repeating pattern in your
Patient’s is worth looking at in this way.
‘Is this me?’
‘Is this my issues/patterns playing out?’
***COMMENT FROM MIJ FERRETT***
Hi John,
I love your answers and have enjoyed reading them and,
for the most part, agree with them. There is one minor
point though … when you say ‘Lastly, if you are
getting that kind of feedback [‘My neck was fine
before I came to see you for back pain. Now it is
really painful.’] a lot, you might need to look at
yourself. Your intention may be too strong. You may be
trying too hard. You may be too attached to what you
think is the right outcome.’
I think what you said is relevant and true but there is
more to say. If you get this kind of comment often then
it is almost certain that there is something that needs
looking at but whether or not you get this kind of
feedback it is inevitable that from time to time all of
us will get drawn into being over-focused and doing too
much and that as a result we will tend to initiate some
kind of protective reaction from the client in response
to our inappropriate interaction. There is a natural
tendency for therapists to deny this so the process of
denial needs attention paying to it as well. In
situations like this it’s useful to spend a little time
reflecting on what has happened and notice any pull
towards being defensive. One of the most beneficial
ways of progressing therapeutically with someone is
admitting when we make a mistake and apologising for
it.
Interestingly this principle has paid dividends in, of
all places, american hospitals*. Any authentic
acknowledgement and apology will tend to help the
therapeutic relationship.
Of course there is the classic healing crisis response
as well and the classic response of the client not
taking responsibility for their own process but that
this can be used as a cover up for therapeutic error.
More power to your keyboard.
Mij
*Due to the litigious nature of the culture and the
large sums of money awarded by damages suits many
hospitals and doctors have tended to cover up and deny
mistakes. However a pilot scheme in Lexington VA
Kentucky introduced after some multimillion dollar
lawsuits, encourages doctors to acknowledge their
mistakes and apologise for them. When patients have
doctors apologise to them and offer fair compensation
feelings are much improved and court awards are much
lower; there has also been a reduction in unjustified
malpractice suits. Subsequently many other US hospitals
have introduced the policy with similar results and
medical students are now being encouraged by Harvard
Medical School to do the same when qualified.
>>>MY COMMENTS:
I agree with everything up to the part about
apologising to the patient when we make a mistake.
For some reason this set my alarm bells off.
‘Apologise to a patient? Really?’
It troubled me.
I wrestled with it.
I pondered, even.
And then it hit me . . . a few times.
Not all apologies are therapeutically beneficial for
both parties.
When I get on an aeroplane I’m not really thinking
about the pilot. I’m thinking of where I want to go.
My destination.
If I did think about the pilot I would have to
acknowledge that he will probably make AT LEAST one
mistake on the flight. I know it but I don’t really
want to think about it.
If we are flying along at 60,000 feet and the plane
lurches suddenly but then rights itself, I want to
think that we probably hit an unexpected pocket of
turbulence. The ‘fasten you seatbelts’ sign didn’t
come on so everything is probably ok.
The last thing I want to hear is the pilot coming
over the intercom saying,
‘Hi Everyone, this is the captain speaking.
Look, the head cabin attendant Nancy, was just
giving me my dinner and when I reached for the tray
I accidentally hit the throttle with my knee.
That’s why the plane lurched a minute ago. So I
just wanted to let you know and I wanted to
apologise to you all.’
The captain would probably turn off the intercom,
look at his co-pilot and say, ‘Man, that felt good.
Therapeutic almost.’
Back in my seat, I would probably have a glazed sort
of look in my eye. My knuckles would definitely be
whiter and while rationally I might appreciate the
pilot’s honesty, most of me would be wanting to get off
at the next stop. Which stop? Who cares?
JUST GET ME OFF THIS PLANE!!!
I would still want to reach my destination, just not
with that pilot. He is probably perfectly competent to
get me there but he just made the process of getting
there too scary for me.
Also . .
The sort of ‘mistakes’ we make are a lot more
complicated and difficult to explain than Doctor’s
mistakes.
‘I’m sorry I left my wristwatch inside you, when I
sewed you up Mr Smith.’ would be understood by most
patients. They wouldn’t be too pleased about it, maybe
they wouldn’t sue the doctor for so much but they would
understand the error.
Whereas if we say something like. . .
‘I’m sorry you had that reaction last week. It was
my fault because I wanted you to get better too much.’
Most patients could understandably reply, ‘That’s
what I’m paying you for. You’re supposed to want me to
get better, ya big freak!’
Equally . .
There is the possibility that we could end up
apologising for responses that are not actually
mistakes but are part of the therapeutic process.
Saying. . ‘I want to apologise for your neck hurting
this week. It was because my intention was too much
last week.’
Is apologising for what is actually part of the
process of finding the best level to work at for that
person’s system. There is no way of knowing it in
advance. You can only find the right level to work at
by going as lightly as possible, while remaining
physically in the room, the first time you treat the
person and then going deeper with each subsequent
treatment.
Assuredly . .
I’m all for apologising to patients if you’re
running late or you haven’t got the right change or you
fall asleep on their stomach!
No kidding, it hasn’t happened to me personally but did
happen REPEATEDLY to one of my students.
Eeeeewwwwww!
Finally . .
Be ruthlessly honest with yourself and appropriately
honest with your patients.