Welcome to 2024! Motion Forword - Words of a Therapist! Number 7!
Motion Forword is about discussing the combined benefits of movement with a positive mental attitude. Using my personal/professional experiences, evidence-based research and some of your own experiences.
Bringing some hope, positivity, happiness and maybe usefulness to those, perhaps like yourself, that needs a pick me up.
Something about me - I’m still in one piece!
I hope you enjoyed your Christmas and New Years and have been combating any subsequent January blues with some warmth and happiness! Either from enjoying the company of friends and family, indulging in the next binge-worthy TV show (OMG The Traitors!) or snuggling down with your favourite hot beverage and a blanket! I decided back in October that I would spend part of my January in an even colder place: The French/Swiss Alps!
I hadn’t skied for 2 years but it is something that brings me joy and scratches the itch of the little adrenaline junkie in me! So away I went on my own to meet a bunch of other solo skiers looking for some fun on the slopes.
We were super lucky with fresh snow and blue skies for a lot of the week. A highly enjoyable week of skiing and indulging in french cuisine like racklet, fondue and Savoyarde-style soups and burgers!
You may be pleased to know that I didn’t hurt myself… too much.
Something for you - Why is Narrative Important?
If you have pain, what is important to you?
Understanding what the problem is? I.e. a Diagnosis
Understanding how long it will last? I.e. Prognosis
Understanding what they can do to make it better/ not make it worse?
What about…
What is the narrative? I.e. What have you been told and what does that make you think about your problem?
The first 3 questions are common queries but what we don’t realise is that the narrative we have been told about our problem can have a significant impact on the first 3 questions… for better or for worse… 😯
This comes back to placebo vs nocebo.
Placebo is something inert that is considered to have no active qualities yet has a positive physiological impact on our bodies. A nocebo has the opposite effect, having a generally negative effect on our bodies.
Let me try and explain with a story…
A story - Words Matter
A long time ago (in a clinic far, far away) I had a patient who was diagnosed with osteoporosis and was told by her Doctor that if they were to fall she would end up in a wheelchair.
This elderly, but very fit and active, lady became terrified. She became scared of doing her normal nordic walking and simply getting in and out of the bath, because she was scared of slipping.
The narrative the Doctor gave was very disabling for this patient. And could actually have the opposite effects they intended because as she became less active, she became weaker and more prone to falls and hurting herself!
If the narrative was something like:
‘You have osteoporosis which means your bones are weaker which is common for women of your age. Unfortunately, it can increase the risk of fractures. But if you keep active, keep up your walking regularly and eat a balanced diet you can actually maintain your current bone density and perhaps even improve it! Reducing your risk of future problems. We also have medications to help you with this and we’ll follow up with you to see how you are getting on.’’
The same scenario, different narrative. Hopefully you can see that I’ve tried to explain the problem and its potential complications but packaged it up in a way that reassures and supports the patient. So not to freak them out!
In my experience and in clinical studies, this positive narrative creates a positive mindset and better outcomes for patients.
So if you ever hear someone give a negative narrative to a person’s problem…
E.g. you walk like an 80 year old, your pelvis is all out of alignment, you have a twisted back, you shouldn’t do that because it will wear out your joints etc
Tell them to sod off!
Because all that is doing is enforcing a negative narrative around the problem and making you worry more and may only be making the problem worse!
Stick to finding positives in the chaos.
Thanks for reading.
Until next month…Motion Forword ⏩⏩Nathan