Flexibility, Awareness, Growth: Resonances Between Psychological and Physiological Healing

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The Surprising Parallels Between Psychotherapy and Physical Therapy

I extend sincere gratitude to Dr. Arnon Rolnick for his valuable contributions to this post, and to my physiotherapist Ron Maimon and his excellent team, for not only facilitating my physical healing but also providing the inspirational spark for these insights.

 

As I lay on the physiotherapy treatment bed, the therapist working on my neck explained that he doesn't aim to directly 'repair' people, but rather supports the natural healing processes of the body. He mentioned that while the slipped discs were a factor, the root issue was the broader patterns of physical rigidity and lack of fluid movement perpetuating my pain and dysfunction. His words struck a chord with me as a psychotherapist, making me reflect on the many parallels between our two fields.

In exploring the worlds of psychotherapy and physical therapy, one begins to notice some striking similarities between these two healing modalities. While one focuses on the mind and the other on the body, there are remarkable parallels in their approaches and philosophies.

A key insight in both fields is that the symptom is often just the outcome - the visible manifestation of an underlying process or rigidity. In psychotherapy, especially Acceptance and Commitment Therapy, practitioners recognize that psychological inflexibility is frequently the root cause of mental distress and behavioural difficulties. Similarly, physical therapists understand that physical rigidity, such as muscle tension or restricted mobility, is often the driving force behind pain and impaired functioning.  

Both fields also recognize how habits that may have once been situationally adaptive can become rigid and maladaptive over time, causing pain and reducing one's ability to live a full life. In psychotherapy, coping strategies like avoidance or mental rumination that provided short-term relief can calcify into unhealthy patterns. Likewise, physical therapy patients often develop compensatory movement habits to avoid discomfort, but these habits perpetuate imbalances and limitations. Bringing awareness to these rigid psychological and physiological patterns is the first step toward positive change.

One way that both disciplines work to address these core issues is through promoting fluidity and flexibility. Psychotherapists guide clients in practising psychological flexibility - the ability to openly experience thoughts, feelings and bodily sensations, and persist with valued actions. Physical therapists, on the other hand, use techniques to increase neuromuscular dynamics and restore fluid, natural movement patterns.

Cultivating self-awareness and interoceptive attunement is invaluable in both psychotherapy and physical therapy. In psychotherapy, developing awareness of one's internal experience is key to psychological flexibility. Clients learn to non-judgmentally notice thoughts, emotions, and bodily sensations, reducing attachment to literal thought content. This interoceptive awareness similarly benefits physical therapy - enhancing body consciousness allows patients to precisely tune into tension patterns, misalignments, and subtle cues from their physicality. The capacity to experience the present moment directly, whether psychologically or somatically, creates opportunities for self-adjustment and growth. For those engaged in both psychotherapy and physical therapy concurrently, the two modalities can markedly reinforce each other - psychological self-awareness informing physical awareness and vice versa in an integrative feedback loop. This holistic attunement amplifies therapeutic progress in both realms..

Both fields take a holistic view of human experience compared to the more topical approach common in traditional medicine. Rather than just targeting surface symptoms, they seek to understand and reshape the broader patterns - psychological, neural, musculoskeletal - that give rise to those symptoms.

Furthermore, there is a recognized interplay between the physical and psychological realms. Physical pain and disability can profoundly impact one's mental state, just as mental/emotional distress can manifest in physical tension, fatigue and distortions in body awareness. Effective psychotherapists and physical therapists attend to this mind-body interconnection.

Other parallels include the emphasis on mindfulness, developing healthy relationships to discomfort, resetting unhelpful movement/thought habits, and empowering self-management skills in clients/patients. The fields mutually respect the wisdom of the human system to self-organise and self-heal when provided the proper support and conditions.

While operating in different domains of human experience, psychotherapy and physical therapy clearly share a resonant philosophy - working not to directly "fix" the problems, but to cultivate the inherent resources and adjustability that allow adaptive change to emerge from within. The fields can likely learn much from each other's approaches to facilitating integrative, lasting growth.

The crucial role of the therapist is another key parallel between psychotherapy and physical therapy. The therapist must deeply understand the unique patient, impart vital knowledge, and cultivate a strong therapeutic relationship grounded in epistemic trust. This epistemic trust - the patient's confidence in the therapist's expertise, perspective and benevolent intentions - is central to facilitating the patient's compliance and ability to fully embrace the therapeutic process. Without a foundation of trust in the therapist's authority and guidance, patients struggle to open up, follow advice, and embody the insights and new experiences being introduced. Epistemic trust allows patients to feel safe acknowledging vulnerabilities, whether disclosing sensitive personal thoughts/experiences or permitting observation of private physical issues. It enables them to trust and adhere to the therapist's recommendations for treatment. Both fields therefore rely heavily on the therapist cultivating rapport and earning this form of grounded trust to optimize outcomes and support the patient's journey as an attuned, knowledgeable, and skillfully caring guide tailored to each individual.

It was an eye-opening realisation as I received that physical therapy - just as in my psychotherapy practice, the symptom is often just the outcome, the visible manifestation of deeper underlying processes and rigidities. By stepping back and addressing those core patterns, whether psychological or biomechanical, we can catalyse the inherent self-adjusting capacities within the whole system of the person