PNF Philosophy #2: Treat the Whole Human Being

This consists of 3 things:

1. Physical
2. Emotional
3. Intellectual

Given PNF Philosophy #1: every living thing has potential, our question needs to be:

“How do we bring out that potential?” 

In rehab or training, the body will have specific adaptations to the imposed demands, otherwise known as the SAID principle.  Generally this is taken to mean that the physical aspect of the client will adapt, but what about the emotional and intellectual? 

Shouldn’t we also consider what demands need to be imposed on the emotional and intellectual aspects of the client? 

A client can learn a new physical movement, but if that client doesn’t believe in you (emotional) or doesn’t really understand why (intellectual), the new movement pattern won’t “stick” – there needs to be a connection to all three systems.

Let’s use the current pain neuroscience research to make this discussion “evidence based” shall we?

PAIN SCIENCE

Lormier Mosley and David Butler, from the Neuro Orthopedic Institute, have provided our profession with some cutting edge research about pain using functional MRI machines (fMRI).  fMRIs basically shows us which areas of the brain are the most active in real time.

So they wanted to find out if there was a “pain center” in the brain. An area of the brain that became active every time someone got pricked with a needle for example.

If they could find one area of the brain that was dedicated to pain then we could potentially remove that area of the brain and all of our pain problems would be solved, right?

What they found is a lot more complicated than that.

Interestingly, they found out that there is not just one area of the brain that is active during a pain experience. There are multiple areas of the brain that are active simultaneously during a pain experience and it can be different moment to moment and person to person.

 Image: Neuro-Tag 

Image: Neuro-Tag 

They have labeled this brain pattern activity as a “pain neuro-tag” as demonstrated in the picture below:

Although the “pain neuro-tag” can vary drastically, one of the common things they noticed as they studied the pain “neuro tags”, was that the limbic system, which has been deemed our emotional center, is always a part of this neuro-tag. 

With this new information, how can we as clinicians possibly address pain without at least considering our patient’s emotional state? Whether we like it or not, it’s a piece of the “evidence based” puzzle, which ultimately highlights our role as clinicians and/or trainers because we are dealing with human beings.

The third piece that we should consider in order to address the whole person is the intellect of the client we are treating or training. This is definitely an art especially when we are dealing with a wide spectrum of individuals throughout the day.

Understanding the intellect of the client is critical when educating the client so we can make sure they walk away saying to themselves:

"This makes so much sense!"
Instead of:
"They are so smart, but I have no idea what they said."

This part of the PNF philosophy was highlighted for me during one of my evaluations with a client. I try using very layman’s terms when articulating what I’m doing and why I’m doing certain things during an evaluation.

So one day as I was summarizing the subjective and objective evaluation to a client, I learned that the client was an osteopath.

I was immediately taken back because her body language and facial expressions never demonstrated “I already know this stuff, I’m an osteopath!”

 I felt as though I had just blatantly insulted this person’s intelligence, but they were so down to earth that it really humbled me. I got lucky that time, but now I make a conscious effort to better understand the intellect of each client that I work with, because what they do or don’t know should greatly affect our choice of words when educating them.  

This seems to be obvious and intuitive, but in the fast pace health care system, it helps when a system holds you to a grounded and defined set of values and philosophies which makes you check yourself after every encounter with a client. This is an example of practicing thee motto "Learn. Move. Grow"

If you would like to start practicing PNF, start this week by asking yourself after a few encounters with clients:

 “Did I address the whole person?”
“Did I address the physical, the emotional, AND the intellectual?”

If the answer is yes, then you’re already practicing PNF and you don’t even know it.

As an ending note, because this comes up a lot, you don't have to get sappy and soft with your clients for 20 minutes in order to address the "emotional" piece. Simply acknowledging that someone is frustrated or irritated and then getting onto movement can sometimes be enough to address the emotional. 

Next post I will discuss PNF Philosophy #3: A Positive Approach. 

Ramez Antoun