I am prompted today to write about physical therapy after reading two powerful, different, and very upsetting links about simply unacceptable treatment (Warning -- potentially triggering?).
I have written about PT before, here, but the stuff I have read makes me want to be a little more open -- even though my experiences are nothing like as traumatic as theirs.
The first is trinityva's post, and the second is an interview with Norman Kunc. Both posts are pretty explicit about physical therapy as a kind of abuse, made worse by the fact that the perpetrators are set up as "helping figures." Both posts clearly link self-esteem and physical therapy, and both make connections between their experiences and the PTSD of people who have been sexually assaulted. Kunc is particularly interesting on this point.
I have had a lot of physical therapy in my life, and I can say that there is a big difference between going in with something fixable and going in as a disabled person. My first physical therapy was for a sprained ankle. I went in; the therapist assigned some exercises; I did them over the course of a couple of weeks; it was over. My second round of PT was for a yanked back. It was basically the same thing. A limited course: exercises, shock and rocks (ice and electricity), ultrasound, massage, more exercises.
Things are entirely different now. I remember when a PT gave up handling my post car accident whiplashed neck. Her excuse was that she couldn't tell what was whiplash and what was disability; she didn't want to be treating the disability. I didn't care. It was all still painful; she could have helped.
I jotted these notes down after a meeting with a new physical therapist over a year ago: (deep breath ... committing this to the Internet)
I think he is nice, highly qualified, understanding of the problems, and creative with solutions. I'm having a hard time with it. I respond to all conversation, but I close my eyes and lock him out. I'm too scared to make eye contact. Part of this taking myself away is a response to proximity and touch. This is BIG touch. Full on body weight to body weight touch. He's pushing my leg with all his weight. It is intense. I have my eyes shut, but he's observing all the time. All the time. I'm backing away from that contact. I have to commit to making his movements as much as I can, or at least I feel it as a commitment. I make the movement, but the physical response is not always perfect. I can't DO half this stuff; I feel bad about that. And then there's a physical sensation that is a response to the movement. It's not exactly pain, but it does feel weird. No, it's pain. I feel apprehensive going into this because of the weirdness of the physical response. It hurts and I feel separate from my body and myself and from what's going on. I feel scared. I can't do it.
Even now when I read those notes, I remember the fear and the pain.
I have had a PT who did not want to work with me at first. We talked about this, and eventually things were fine. BUT it was awful for the first couple of appointments. When she met me, she was worried about how much control I had and whether or not she was going to be able to "manage me" -- didn't ask what that meant. She was also explicit about how neurological work can be less than rewarding because people simply "don't get better."
And get my response? Did I say, "Well, stuff you then. I'm out of here." No. I did not. I wanted to be the "good client," the one who would "get better." I would show her.
When another PT had the bright idea of strapping me into a standing table before a room full of way-too-interested people, did I say no? No. I let him make a spectacle of me. I let him strap me in and watch.
When I first started doing work for my legs, my appointments were scheduled at the same time as "Richard's". I never knew what Richard's story was -- the PTs frequently teased him about having taken a dive off a long cliff into a short pool. Richard was, they informed me, a recent T-6; I didn't know what that meant. I just remember staring as they hauled the guy around (bad me -- sorry, Richard. Didn't know any better). During the months that we were there together, Richard never spoke unless he was in pain. He never acknowledged the mean joshing that went on around and above his head. He knew his failures were the entertainment for the day.
I have now been in that position.
As I wrote in my earlier post, my PT these days is mainly in a safe, private space. It's about relief, stretching, realigning, damage control, damage mitigation, performance enabling. I still hate it, but both my East and West Coast PTs and I have come to a semi mutual agreement about what to do. I am mostly safe. West Coast PT wraps anything she's not working on in blankets (of the leopard print variety ... grin). She's got a great office. The East Coast guy works in my home; I choose the music and I get to drink coffee. Neither of them forces anything. Neither of them asks more than I can do.
But I still FEEL unsafe.
I still feel like my body might do something weird and embarrassing. It might let me down. It has let me down; that's why I am there. I still feel like they may suddenly grab, twist, pull. Pain could start at any moment.
It feels bad to be lying on a table waiting for the PT to begin, knowing that his/her touch will set off a round of uncontrollable jerks/spasms.
It feels bad to be lying on a table jerking around (even when you can see the Empire State building from your window).
I still close my eyes -- turn my head -- so I don't have to see them.