Patient/Practitioner Relationship, Part 1
By John Veltheim, D.C., L. Ac.
During my many years both in practice and teaching practitioners at the undergraduate and postgraduate levels, I have remained interested in the underlying, often hidden, factors that seem to influence the results of a course of treatment. On many occasions, I have seen patients treated by a practitioner using a specific technique without a result. Later, I have seen a different practitioner use the exact some technique on the same patient with great results.
Conversely, a practitioner can treat one patient with a particular simple disease and have great results and yet have bad results with another. This led me to start observing the apparent ‘qualities’ of both the practitioner and the patient that seem to contribute to the differing outcomes. I have further found that some of these qualities can differ within a patient or practitioner from day to day.
For example, my results in practice were usually better when I was very busy. They decreased if I had plenty of time on my hands to see the patient. As will be seen later, this variable had to do with my state of focus. Patients can vary in their moods from treatment to treatment and change the results! I have consequently postulated the immense importance of the practitioner – patient relationship with regard to results. This will be discussed later to evolve the dynamics of this relationship and the ways it profoundly governs long term results.
I hypothesize that the following is a list of ingredients that contribute to the total picture beyond the obvious medical conditions and standard biochemical and physical medicine factors. Any combinations can contribute positively or negatively according to the situation. These ingredients apply to all therapies to some extent, but are particularly important in ‘energy’ based therapies such as Bowen they, BodyTalk, Applied Kinesiology (muscles testing), Reiki, massage, etc.
Please note that the following is a description of what often is. It is not meant to be a prescription for what must occur for results to happen. It can be detrimental to enforce changes to meet these descriptions, because the trauma involved in making either party conform to the ‘ideal’ conditions may outweigh the benefits derived.
The “Perfect” Patient:
Really wants to get better. This seems a silly statement until we look at the reality. Most patients only want to improve their symptoms! They want pain relief, symptomatic relief, and the ability to get on with their own subconscious concept of ‘functional’ life.
I have generally found that the patient often does not want to do what is necessary to completely get well. For most, it would be too much trouble or too ‘difficult.’ The often made statement – “Doctor, I’ll do anything” really means “Doctor, I’ll do anything so long as I feel comfortable doing it, and it won’t inconvenience me, or confront me beyond my comfort zones.”
Naturally, the disease they present with is there precisely because their ‘normal’ comfort zones include the attitudes, habits, and beliefs that caused the disease. The only way to permanently overcome them is to go beyond them into the discomfort zone. In many cases, the symptoms are also a personality crutch that elicits sympathy, or excuses, in life to gain much needed attention from family or friends. They, therefore, want to have only the severe symptoms reduced to enable the problem to return when it is ‘needed.’
Until willing to release obvious self-sabotaging belief systems, the patient holds onto belief systems that are obviously unhealthy. By continuing to adhere to that life style/attitude, lasting results are made impossible. E.g. “smoking doesn’t really hurt me and isn’t the cause of my cough;” “the health food trend is nonsense, I can eat all the sugar I want;” “stress doesn’t hurt me, it keeps me sharp and successful.”
This takes us back to the previous situation where the patient has to surrender a comfort zone to obtain true health and is willing to release attitudes and rules often fully accepted by society The patient has belief systems that are in keeping with conventional wisdom but are undermining their health because of the inner reactions they are causing.
Whenever a person holds beliefs that create expectations or assumptions about life, they are set up for reactive ‘buttons’ that will have severe ramifications on their health and slow down any recovery. The imploding emotional reaction damages the bodymind immeasurably. These beliefs have become part of the inner makeup of the mind’s parameters for living. They constitute the blueprint for the energic makeup of the body that essentially controls the nature, structure, and function of the bodymind.
Many studies have shown that when someone undergoes a paradigm shift that causes a spontaneous letting go of previously held detrimental belief systems, spectacular healing can occur. In this instance the patient has become open and receptive mentally to the treatment.
When the patient has a closed, rigid, mindset, the energies of the body take on an unresponsive rigidity. Further, the mind feels confronted by factors that are asking for change and puts up a fight. It will sabotage the treatment and ensure that the communication channels it controls do not function as a dynamic interactive process. Inflexible, rigid minds are the by-products of a society that encourages inflexible ways of thinking.
It does this in the erroneous belief that it will bring forth harmony within the society. The conditioned mind accepts the disease as part of its role in society. When a person is faced with the need to change in order to heal, resistance becomes mandatory. This is the only way they think they can maintain their rigid identity.
The ‘Perfect’ Patient:
Is open and receptive physically. Although there is obviously a close interdependence between the mind and body, this statement refers primarily to the mind’s attitude to the body. If the patient is conditioned to feeling ashamed of their body or has low self-image, they will resent having to expose their body to treatment – physically or metaphorically.
For example, they may be unwilling to undress for the treatment even when it is explained that all energy therapies work better when the patient is undressed. Further, when the treatment does not require them to undress, they will not be ‘naked beneath their clothing’ in order to facilitate that open receptivity of mind and body that will greatly enhance the treatment.
When the patient cannot overcome destructive, negative, societal conditioning and succumbs to non acceptance of the body, it shuts down the surface energy (wei chi) of the body. This debilitating factor reduces the ability to process the effects of the treatment and communicate the positive energy changes to the body.
Further, because the body is effectively attempting to ‘hide’ itself metaphorically, or behind its need for clothing, the body energies tend to withdraw into the deeper recesses of the body where it is harder to influence them. If the body is not locked into environmental emotional patterning then the emotional state of the body can totally control the body’s health and ability to respond to treatment.
Many practitioners think that they are dealing with the emotional disorders of the patient when they are treating them. What they often do not realize is that the patient who has the symptoms of low self-image and/or poor wei chi, is very susceptible to the emotional states of everyone and everything interacting in his/her daily environment.
Very often, the practitioner is unwittingly treating the anger of the spouse, or work colleague, and not an intrinsic emotion of the patient. While the patient remains in that environment without the tools to raise self-image and strengthen defenses, the treatment will only ever be a Band-Aid.
When the patient is willing to surrender to the treatment and trust, the key word here is trust – of the practitioner; of the procedure; of the patients’ own willingness to trust change in the bodymind; of the patient’s confidence in his/her ability to live in a healthy state.
However, there is still a point where the patient must surrender to the treatments, and the consequences of them, before total healing can really occur. This is primarily a mental process of going beyond the rigidity of the defensive, reactive mind and trusting, at some level, in the flow of life and normalcy of living disease free at all levels.
Although this state will not be achieved in most treatments, the undercurrent of this trend needs to be present at some level before any therapy can bring about the paradigm shift of awareness that is true healing.
This is probably why I feel that any worthwhile therapeutic interaction should include tools for generating awareness in the patient, and systematically tearing down the walls of ignorance in the form of indoctrination and rigid life rules.
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The ‘Perfect’ Practitioner:
(Most of the following factors are identical to the criteria for patients.)
Really wants the patient to get better. Consciously, or subconsciously some practitioners need their patients to continue seeing them. In rare cases, for financial benefit. In other cases, it is because they need the praise from the patient and require the patient to need them. If the ego of the practitioner needs feeding, it behooves him to maintain an ongoing dominant relationship with patients to give continuity to that need.
Is willing to release, or put aside, their own self-sabotaging belief systems. I have seen many practitioners ignore certain destructive life styles in a patient which mirror their own self-destructive life style. “I can’t see the smoking hurting you, I smoke too and it isn’t hurting me.” Is willing to release their own socially acceptable attitudes and beliefs.
While a practitioner is caught up in the indoctrination of society, this can greatly affect their judgment. It will cause them to react rather than respond, to the information gained through observation of their patient. It will also shut down, or distort, their own energy patterns, which will constantly have a negative influence on patients. This influence is stronger when both parties allow practitioner dominance to occur in the practitioner – patient relationship.
Has confidence in herself. If the practitioner does not have confidence in herself, she cannot expect the patient to have confidence in her.
Is open and receptive mentally. When practitioners are shut down, opinionated, and rigid in their thinking, their scope of practice is limited. Their ability to adapt their treatments to the unique needs of a particular patient is compromised. Their mental blocks will often blind them to other possibilities of treatment, and limit the scope of their ability to facilitate and restore balance. Because of their powerful influence on the patient, they may even impart some of those negative attitudes to the patient causing additional long-term harm.
Is open and receptive physically. There are constant energy dynamics taking place between the patient and the practitioner. This is happening at levels beyond the normal verbal and physical interaction of therapy. When there is a deliberate linking of two people for healing, the energies of those participants start dynamical systems interactions that powerfully influence the end results. This often happens long before the ‘actual’ treatment begins and can make or break the end result.
If the practitioner has poor wei chi and poor self-image, this can project onto the patient in many ways. I have constantly seen that practitioners who have problems with patients around body image are, themselves, in emotional and mental conflict with their self-image at some level. E.g. they are embarrassed to be seen undressed, etc.. Further, a practitioner who has withdrawn energy has less chance of being able to dynamically affect the energy changes needed for the patient.
When a practitioner using energy therapies is treating a patient, his own dynamic (or non-dynamic) energy profoundly influences the results. The ‘shut down’ practitioner surrenders the treatment edge to the practitioner who is dynamic, open, and receptive.
Is willing to surrender to the treatment. This concept will be discussed more in the summary because it encapsulates a very important dynamic. At this stage I should also address the need to remove the ego from the equation so that all the factors discussed so far can evolve.
While the practitioner needs his ego fed, and believes she is the healer saving the patient, the factors are reinforced negatively. When the unhealthy ego is engaged, all the attitudes and belief systems supporting that crippled ego are reinforced and amplified. Hence, all the criteria for a dynamic healing are inhibited.
Practitioners must see themselves as privileged catalysts. They are present as part of a process; the causative dynamics of which go far deeper than the mere bodymind present in the treatment room.
A dynamic interactive relationship exists between the patient and the practitioner. Each participant is there to fulfil whatever result, good or bad, may be forthcoming. Likewise, their presence and mutual interaction is the outcome of numerous predetermined factors inherent within each.
Universal laws such as synchronicity and sequential cause and effect influence the final outcome of any treatment. Actions are irrevocably taking place between the two players involving all the dynamics thus far described. These are descriptions of the game of life.
By understanding this process, we can arrive at a philosophical understanding that will transmute the apparent struggle of life into a process of exciting events to be observed and played out. During this process a deep awareness may occur at various levels in each participant that can transform lives.
There are various stages of these dynamics that depend upon the state of awareness of each participant and are relative to the factors described so far. These dynamic stages between patient/practitioner will be discussed by Dr. John Veltheim in our next issue of Health Mastery Ezine.