Episode Transcript
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can eat buffet cart. Hello and welcome to this latest
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episode of You Matter. Hello and welcome to You Matter.
In this episode, I welcome back my good friend Joanne Elfenstein
with a very specific remit for this session.
Joanne and I are launching something very exciting in the
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New Year called Coaching Unpeeled.
And we are more than aware that coaching has entered not just
the clinical sphere, but seems like, you know, life in general.
Everybody is talking about coaching in different forms and
you may be looking on, you mightbe curious, you may know a bit
about it coaching, maybe you're wondering if this might apply to
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you in your life and particularly in your clinical
life. We think it does, but in a very
specific and particular way and that's what coaching Unpeeled is
all about. So we're going to, as is our
usual way, riff on that together, see where the
conversation takes us. But ultimately the aim is to to
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tell you a little bit more aboutcoaching unpeeled, what it's
going to look like and, and whether it might be something
that you're interested in. So sit back and just enjoy the
conversation about coaching. And if you're interested in
hearing more about coaching Unpeeled, then we give you some
ideas of how to do that later. And just as a little personal
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aside, this is going out on my birthday, December the 8th.
I hope if I got my calculations right as to the launch date of
this episode. So why do I need to tell you
that? Well, happy birthday to me and
what a lovely way to celebrate my birthday to have this episode
with John going out. I hope you enjoy it.
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Take care. Don't forget to sign up if you
are interested in coaching Unpeeled and I will back be back
again at the end to remind you of what to do Take care.
Hello and welcome to this next episode of You Matter.
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All my episodes are a pleasure, but this is an especially large
pleasure. Especially big pleasure because
I am thrilled to welcome back toYou matter, my good friend and
colleague Joanne Elfenstein. Hello, Joanne.
Hello Joe, it's very exciting for me too.
I had such a lovely time last time I was with you, so I am
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looking forward to another beautiful conversation.
Absolutely. So Joanne and I are here for
quite a particular reason together today.
The title of the episode should give you a hint.
Everyone's talking about coaching, and Joanne and I've
been talking about coaching quite a lot because we have
something very exciting launching early next year.
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It's coming under the title of Coaching Unpeeled, and that
title should make a little more sense as you listen to our
conversation today. But Joanne, I'm going to hand
over to you and let you explain a little bit about what we are
doing with Coaching Unpeeled. Sure, Joe.
Well, this is just such a lovelyopportunity for us both to do
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something we really care about. Joe, I know has the same
motivations as I do for clinician well-being and, and
standards of practice and all those lovely things.
And a lot of people are talking about coaching right now.
And obviously it's something that Joe and I know quite a lot
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about because Joe, as you'll be more than familiar with how much
Joe has been doing in the field.Those of you who've trained in
GEMS also know it's been part ofthat for all 20 years or so.
But suddenly it is in the general conversation now and you
might be wondering what it's allabout.
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Is it relevant to you? Is it something that would be
helpful in exploring and, and what we've done is taken all of
that experience and a considerable amount of training
and we did it all out to bring it right down to what is going
to be the most powerful and helpful for you in clinical
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practice, hence coaching unpeeled.
So yeah, there we go. Yeah, we've we've already given
ourselves the opportunity for loads of references to zest and
pith and even taking the pith out of ourselves.
Occasionally I just think takingthe pith is just gold, yeah.
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Yeah, we're going to have. To We're not taking the pith
here. Yeah, exactly.
But yeah, Joanne's absolutely right.
There's a, there's a whole worldof coaching and variations of
coaching approaches, people applying it in all sorts of
different arenas. The thing it reminds me of
actually is when mindfulness started and we all wondered what
it was and was it just for yogisand people that were really into
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meditation? And then suddenly there was
mindful walking, mindful talking, mindful playing with
your kids, you know, mindful everything.
And I think coaching is going through a little bit of that
process itself. And many of those things are
really good things. Coaching principles can
absolutely be applied to work and so many areas of life.
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But because it's that way, we felt for clinicians, we wanted,
as Joanne says, to really distill it down to demystify
coaching a little bit, but also to make sure that we were
talking about the bits that are really relevant to the clinical
scenario and also really relevant to you as a clinician.
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Because we're going to talk in amoment about those two sides of
it. We often go on courses, don't
we? And we're really invested in
what we can learn to better our service for the patient.
And it's not always, it's not always in our mind to consider
how that actually benefits us. But one of the beautiful things
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about coaching is that it can bethis two way process.
And yeah, I think that's where alarge part of the value is here,
that yes, you can apply it clinically for your patient, but
it's going to open up so much opportunity, so much freedom,
and I would say from personal experience, so much relief for
yourself as a clinician. Joanne, do you want to speak
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about that a little bit more? Yeah, no, absolutely.
So it's it's so interesting because as Joe said, we go on
these courses and we learn techniques to do often to the
patient and that is absolutely not what coaching is about.
With it comes this sense of it is my job to fix the patient.
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So the full shouldering of all responsibility, which is heavy
and actually possibly not in thethe patient's best interests and
not in your best interests. So it's interesting because in
this funny binary world we live in, we often assume that if it's
better for the patient, then it's OK that we sacrifice a bit
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from ourselves. Or if she we should actually
decide that maybe we should do something that is making our
feeling of being in our job moresustainable, you know, more
enjoyable, heaven forbid, more enjoyable, then somehow we're
taking something away from the patient.
And it's a really interesting little paradoxical feeling that
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we have inside about this, that somebody in this interaction is
it's going to cost. And I think the, the joy of
understanding how coaching principles can help you to frame
your clinical interaction, you know, really things that you
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will all relate to, like management of expectations.
How many times do collections tell me that they're, they're
thinking that the patient thinksthis or the patient thinks that.
And I'm like, really, how do youknow that?
And then you realize it's a grand assumption based around
anxiety, which is around expectation management.
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All of that can be sorted out with some really simple
principles. And that's just one example of
how you can start to ease some of these areas of real tension
for yourself and at the same time really provide some clarity
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for the patient and give the patient the opportunity to
really start to step into this with you.
So it isn't you here with all the responsibility, carrying the
patient on your shoulders and then saying, oh, well, the
patient's not taking responsibility.
Well, yeah, of course they're not because you're taking all
the responsibility. You got to create some space for
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them to step in. So there's just so many elements
in the clinician experience, youknow, that anxiety, you know,
and that feeling, oh, I didn't get it right, for example, or it
didn't work. OK, we can talk about that a
lot. Whenever someone says, oh, I
tried this, it didn't work. So what does not working mean to
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you? And then when we step back and
then look at that again and go, So what did we learn from it?
Instead, the roadblock stops andthe motion gets going again.
So there's just, there's lots ofelements around the, the things
that I know, Joe, you'll be encountering in your coaching
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that I encounter my own coachingand my teaching that clinicians
just again and again struggle with and leads them towards
burnout and feelings of not coping and feelings of not being
good enough. So many of these things can be
helped with some really simple principles and some really
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simple structural elements that can ease a lot of that.
Yeah. And I wonder if it's worth for
people that haven't experienced coaching at all or either, you
know, received it or had any education, I wonder if it's
worth me just outlining a littlebit about what that structure
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is, because I think straight away clinicians listening in
will be able to see how this does apply so beautifully to the
clinical interaction. So partnership is an absolute,
you know, gold standard tenementof coaching.
And to me that's why it's so topical because how many times
do we hear that the modern evidence based way to work with
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a client is in partnership to empower your patient to give
them agency. And the way you do that within
coaching is that you begin a session or a, you know, a clinic
session or a coaching pure coaching session with, well, an
agreement comes early, but not right at the beginning.
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You can't agree on something until you have learned something
about your patient first. So you come from this place of
curiosity. Your patient turns up that day
with something going on. And it may be something you
already know about because it's not your first session.
Or they may be in an entirely different state to the state
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they were in when you met them on their first session.
Whatever you, you start from this place of curiosity.
Where are you at today? And from that interaction
between the two of you, which may involve quite a number of
questions and answers between the two of you, you then get to
the point where you agree together what the end point of
that session is going to be. So that's the first thing that
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you, you agree together. And critically, that isn't you
telling the patient it is genuine, genuinely in agreement,
which you couldn't possibly havepredicted beforehand.
This is one of the first places to try and shift, you know, try
not to know, try not to predict.Just allow your patient or your
coaching client to to tell you or to lead you agree with you.
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Once you've made that agreement,you then agree how you're going
to get there. And that might be two or three
steps and then you agree where you're going to start.
So I'm not going to give more away than that now, but I hope
people are starting to realize that the reason there's so much
relief around this is you're notactually leading or providing
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anything. You are just asking where are
you now? Where do you want to be?
What steps do you think we need to take to get there and where
should we start? And.
That. Covers off quite a few things.
Joe and I had a quick conversation before we pressed
record around the issue of compliance.
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I think, Joanne, you said you were actually asked the question
by somebody. Well, how do you, how do you
deal with compliance when you'reusing a coaching approach?
I mean, actually, I hope what I've just described has
illustrated that compliance is implicit within a coaching
approach because the client has LED it.
They have told you what they want to do.
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It's come from them. So therefore, you know they they
must be OK with that. Of course, you can record it and
your notes will make that compliance more robust, but
compliance is really implicit inthat process.
Now, there were two things when I started this line of thought.
I was going to say it leads you to compliance.
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And the other thing is behaviourchange and adherence to to, you
know, exercise regimes, agreements around what you're
going to do between sessions. You'll see if you start to adopt
this approach with coaching clients or patients that there's
so much more, so much more adherence because it feels
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personal. They've, they actually came up
with the solution themselves. They came up with the method
themselves. Therefore, it makes sense to
them why they're doing it, and they really understand what
they're doing because basically they designed the process, not
you. Yeah, You know, it's so true
what you say, Joe, you know, around, you know, the issues of
compliance. As you know, I was saying too
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early as someone had asked me like, you know, you know, how do
you manage patient compliance? And and as I said, I was like, I
don't actually have a complianceproblem.
And they were a bit, you know, perplexed by this.
So. Well, yeah, that usually comes
in the same kind of categories. Yes.
But how many reps and sets do you give people?
And the answer is what can be managed in their life.
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So I'll give you an example. I've got a lovely patient.
She is right in the maelstrom that some of you might kind of
relate to. She's in her 40s.
She's got three children and a husband.
And there's, like, school runs and activities.
Everything's going everywhere. Her son arrives at the foot of
her bed at 6:20, fully dressed for school and expecting to go.
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And and so the the answer to thequestion is, OK, where in your
day do you have a slice of time?And we, we found that the the
time of the day was between 6:00AM and 6:10.
OK. So 6, does that sound feasible
to you that that's manageable? Yeah.
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No, it's OK. I'll wake up anyway.
I'm just lying there kind of contemplating how I'm going to
get through the day. OK, then does that sound like a
a good time to be able to commit?
Yes, I'd really like that actually, because I know that
that's time for me to just focuson this before the hurricane
starts. Perfect.
So, So what are we doing there? We're doing what's going to fit
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in that time slot. And we've had that agreement.
Now, if she comes back and said I haven't managed to do it, then
we get to find out. And you know, what are your
feelings around that? Well, it could be either.
I just haven't find the motivation.
But that very rarely ever happens.
Usually there might have been other stuff that's come into
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life. And once we hear about that,
instead of feeling so down on herself, which is exactly where
she went straight away. So actually, you know, the fact
that you have a mother in hospital with a suddenly
diagnosed terminal illness on top of everything else has
created a bit of, you know, issues with the bandwidth.
And it's OK because, you know, tomorrow's another day.
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And so there we go. And so other people will want
more. If we're going to really talk
about patient, like patient autonomy, this is a big one for
me because we're all about, oh, yes, patient autonomy.
But we cannot be saying that while taking all the
responsibility and then dictating what happens.
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So if I I have occasionally had,because I tend to work with
people with more chronic and persistent problems, a person
who we've made an agreement and they've come back and not done
it. And really it's just all been
about just not committing to theagreement.
How do I respond to that? Well, I'm going to ask them some
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questions around that, but I'm also going to have a very, you
know, this, this is all I have to offer you.
We made an agreement. I can't actually do that.
There's nothing else I can do. How are you choosing to go
forward then? Because it's fine.
But I don't have anything extra.So possibly I'm not the person
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for you. And I know people like, you
know, you get the patient go. I'm like, well, yeah, I don't
have a problem with that becauseactually if they don't go away
and reflect and then come back and say, OK, that is an old
pattern and now I get it and I'mready now, great, we move
forward. But what I don't do is put
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myself in a situation of continued energy expenditure
over responsible when if I actually honor the fact that
this person is making an autonomous choice, I have given
them the information for them tomake an informed choice.
And if they do not choose that route, they have a right to
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that. Yeah.
But that I don't have to keep supporting that when I know that
actually that's not benefiting the patient and it's not my role
to keep facilitating that pattern.
You're so right. I have so many clinicians,
particularly more junior clinicians, come to me.
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Maybe we're talking about it a patient they're struggling with
and more often than not there will be this whole list of OK,
they came to me with a shoulder problem.
I tried this exercise, I tried this technique, Then the next
exercise wasn't better. So I tried this, I tried that.
And you're right, the the default is to just keep changing
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and keep pulling out something else from the tool kit, not
investigating, as you say, why maybe why a technique didn't
work, but more importantly, why the patient didn't engage in
maybe what you told them to do rather than what you had agreed
to do. And I love lots of things about
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that case study you've just shared.
A yes, you got her to recognise the fact that there was 10
minutes in her day. And that's probably the biggest
lesson she took home that day, that, of course, her life.
Felt like this because it was sofull of all the
responsibilities, but also then to realize that that was her
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opportunity and it was her choice to take it.
And of course we know that if she chose to take it, that
probably would shift her mindsetand allow her to find other 10
minute slots in her day. But yeah, it's entirely her
choice and it it's not your responsibility or the treating
clinician's responsibility to shift focus just because one
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side of the agreement hasn't been upheld.
And that's a thing where, you know, coaching sometimes I think
can have a reputation of being abit nicey, nicey.
And you know, it's partnership is just all about not telling
and being this curious lovely person.
Sometimes it's about being really strong and holding your
line until such time to move on.Absolutely.
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I mean, I had a lovely thing come up on recent, you know,
poaching retreat that I just did.
And I was describing this kind of a situation and then someone
said, but don't you feel sad? I'm like, why?
Is it because you could have helped them?
I'm like, I didn't feel sad at all.
And they were, they were a bit perplexed.
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And I said, well, if I'm going to honor the fact that this
person is autonomous and they are making a choice, then I
don't have to keep an emotional tie to that, You know it it.
And that doesn't make me a terrible, awful person that I'm
not kind of keeping all these emotional ties.
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But I could, I could save them. No, I don't feel sad because I
know I've given that person the best shot I'm able to do.
And maybe someone else will givethem a, a different kind of
thing. And it's OK to.
But I honour her choice and let's go.
Yeah. And then I'm, I'm good with
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that. I don't have to carry these.
And we are caring people. And this is again, I think, you
know, I'm sure you come across this to do that conflict between
feeling like you want to be a caring person, what makes me a
good person and having my own boundaries and and also
understanding that other people are making choices and we don't
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become better people by taking their choices from them.
And we're going to include that,aren't we, in our course that
self regulation, boundary setting self worth really, which
is a really important part of upholding your part in this
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process. And do you find though, like
people, certainly I, I find for myself, but I'm pretty sure you
probably do too, that one of theissues for for clinicians is
often their self worth is taggedto the outcome of the patient.
So your feeling of actual independent self worth is not
independent at all. It's constantly dependent on
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other people and actually that that isn't self value.
Yeah, and outcome of a session, outcome of a whole treatment
protocol. So often this is more impure
coaching necessarily than in physio, but I often get the
feedback of fun from the from the client.
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Oh my goodness, I had no idea the session was going to go
there. And invariably my response is,
well, I definitely had no idea. And that's the point.
It's it's such a relief to give yourself permission to have no
idea where a session is going togo, but to trust yourself and
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the patient that it will go exactly where it needs to.
And so whatever that outcome is,which you can't predict, it's
the right outcome that day and the two of you got there
together and then you'll move onto the next session.
It's, it's such a relief. Well, it.
Is well, it's a relief when we get practiced with it, isn't it?
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Because initially it feels really wobbly.
Yes, it's confronting, isn't it,to start with?
Yeah. I mean, remember when we trained
and we got taught that we're writing our notes and at the
bottom was the P for plan for what's going?
To happen. And and you know, I still do a
little pee that sounds a bit weird.
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We'll leave incontinence out of that, but we'll but the, the,
the plan I do write some notes for where I think that I think
may be helpful in a subsequent session. 9 times out of 10, none
of that happens exactly the reasons that you've outlined.
But actually by allowing ourselves to respond to what's
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really there now in the present,interestingly, although
initially you think that feels abit vulnerable, actually you're
responding to what is real. And you can actually deal with
that instead of trying to squeeze whatever's showing up in
the patient that day into something that's not actually
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relevant for them today. And that causes an enormous
amount of stress. Yeah.
But as you say, when we start tokind of go, OK, going to anchor
myself here a little bit and let's respond, Yeah.
Yeah, Listen and respond. Absolutely.
And as you just said, yeah, thatrequires some listening.
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And listening's interesting, isn't it?
Listening and hearing being 2 completely different things.
Yeah, listening, waiting to add your wisdom and your reaction is
very different to listening and just allowing yourself to be
present and really hear. And I don't know about you, but
I constantly have to quiet the voice that is going on.
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What are you going to say about that?
And oh, what's the next thing? It really takes practice as a
clinician to dull that voice. And when I started coaching
festival, the feedback I constantly got from my non
clinical tutors were you couldn't resist it.
You held off rescuing for about 3/4 of the session.
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But there it was every time. When am I going?
When am I going to be able to give up the rescuing?
It is it's implicit. And as you say, we're nice
people. We want to care, but and it
takes time just to relax that rescuing muscle a little bit.
But I think the first time you feel the success of it and you
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witness the success of it, it really bolsters you to to try it
again, like any new skill. Yeah.
And absolutely. And when the patient leaves,
because they actually owned thatyou've gone there together.
And again, you know, just so we kind of like nail it down to
something a little bit concrete.It can be something as simple as
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you're doing, you know, an exercise or a movement or
whatever. And instead of just teaching,
this is the exercise and then saying you should feel this,
this, and this, which unfortunately for the patient
who doesn't feel that is we're kind of moving into the shaming
inadvertently. But if you're kind of told you
should feel this and you don't, the patient's in this situation.
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And then the the therapist starts to go, they start to
power up because we need to makethis happen.
And so now both parties are highly stressed, and the whole
thing can be avoided by saying what's so interesting?
So what do you feel? Oh, OK.
So you feel that instead. So let's let's take something we
all know, a basic bridge. Yeah.
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And you're doing this. And in your heart of hearts,
you're hoping that the patient was going to go, oh, I really
feel my glutes. And your patient doesn't.
And hands up, how many people have had that happen to them?
And then we either turn that on ourselves as therapists going Oh
my gosh, it didn't work, you know, or the patient going Oh my
God, it's the same as always. I've seen 5 physiotherapists and
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my glutes have never worked and it's just the same again.
So there's something really, really wrong with me because of
course we're over here, there's a physio going or the patient
thinks I'm rubbish because they're not feeling their
glutes. The patient is thinking, the
therapist thinks I'm rubbish because my glutes don't work and
clearly they must do for everybody else.
So you can see where all of thisdialogue is going on between two
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people in their own little worlds in that space.
And if we just stepped out and went, what do you feel?
Well, I really feel, you know, my hamstrings.
I'm like, OK, that's really great feedback.
So remember that. Now let's see what happens if we
move your feet a little bit closer towards you.
What happens then? Oh, OK, so that's kind of a
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little bit closer towards my hip.
It's still my hamstrings. OK, great feedback.
So now let's just change this thing again.
Now tell me what you noticed there.
And so all the way along, they're actually telling you
their real time experience. Their feedback is as important
as whatever you bring. You're not just trying to fix
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it, you're actually saying you're going to bring your
expertise, which is your felt experience.
I'm going to bring mine for how I might actually alternate in
some way. And together we will find our
way to a different outcome, evenif that outcome is this is
actually not the best way forward for you, this exercise.
And that's not a problem. Sometimes we have to step aside
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to the side to find something else that the brain can make
sense of. And you've just spoken a little
bit there given to when I wantedto make sure we covered, which
is around this idea of expertisebecause I think people often
hear coaching and think, oh, OK,well, that's just dumbing down.
You know, there's not much evidence base for all the
techniques I've learned. And now this coaching thing's
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coming in and it seems like, youknow, I don't need to give any
answers. I don't need to provide any
solutions. I just need to listen and be
present. And, you know, isn't that all
just a bit easy? And I, I like the fact that
there might be a sense of ease around it, but I think it's
really important that we retain our identity as experts.
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I don't know what you think, Joanne, but there's, to me,
there's definitely a dance to play between coaching and what
it might be called outside of the clinical world, a dance
between coaching and mentoring, where mentoring is.
You know, I have this experienceof the thing that you're asking
me about. I've, I've walked this past
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before and then so I'm going to give you the benefit of my
experience, but I think it's slightly different in the
clinic, clinic clinician patientinteraction in that you did go
to college for three years. You did learn from seniors.
You have done lots of reading, you have done lots of courses
and you've picked up this expertise which the patient is
paying for. But you'll smile, Joanne,
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because I, I quote you time and time and time again.
It's one of my favorite things you've ever said to me.
You said coaching or partnershipis not about withholding your
expertise. It's just knowing the exact
point of when to land it. And I love that so much because
to me, that describes this lovely, easeful place of
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curiosity. And then it recognizes the point
at which a droplet of expertise will move from a stuck place.
The ideal is the patient has actually asked you for that
piece of information. But let's be honest, they might
not because they might not actually know that that is the
thing in that moment that's going to shift them.
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And we are still experts, we arestill clinicians, We still have
the mandate. And in fact, we should deliver
that piece of expertise in the moment.
But the difference is we're not.We're not just firing expertise
at them when you know, for them,it's probably like trying to
drink from a fire hose sometimeswhen a clinician is just firing
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all this information and expertise over and over and
over. It's what I love about your,
your, your sentence is, it's this beautiful moment of, Oh
yes, that's just when I needed it.
Not before, not too late, just at the right moment to help us
move on. Well, first of all, I'm grateful
that you actually like can give me my own words back, Joe,
(32:45):
because, because usually someonesays, oh, when you said this,
I'm like, oh, that's quite good.I don't actually have any
regulation. Once it's out of my mouth, it's
gone. So thank you for that.
But yeah, it's super important. I mean, I, I was reflecting on
like even just my patients yesterday, beginning of the
week, I'm like, you know what, Ihad patients yesterday I could
(33:05):
not have treated even a year ago.
And that's after 30 something because, you know, I've kept
developing my expertise. And so we in no way are
undermining that. But as you say, it's, it's about
not actually bludgeoning patients with it when that's not
(33:26):
in, I mean, overdosing. Let's look at broccoli.
OK, Let's just take a complete science step here into the
vegetable world, though. We all know broccoli is good for
us, but it's good for us becauseit's actually mildly toxic and
it stimulates, you know, our systems in order to, you know,
be more robust immunologically. So, but too much broccoli is a
(33:46):
bad thing. You know, just enough broccoli
is good. And it's the same with us
bestowing our, I mean, I say bestowing because that's what
tends to happen. Bestowing and bludgeoning.
There are two things I see. I wrote a piece a while back
saying is in our in our efforts to do patient education, is
there any learning going on? Because we kind of think that if
(34:09):
we just keep talking to someone's prefrontal cortex and
stuffing it full of all our marvellous facts, that somehow
they're going to change. A lot of the time they shut down
because we stuff their prefrontal cortex with all of
that. And then we ask them to feel
something totally different partof the brain.
(34:31):
And we haven't set them up to succeed with that.
And that's when you end up with patients who just learn movement
rules or then they come back andgoing, I haven't been very good
about this or my knees doing that and you know, it's going
nowhere because they haven't felt anything different.
So that's the other thing too, is that all that knowledge that
(34:54):
we have is important for us. We then have to be discerning in
what are the, as you said, the droplets that can land in such a
way without overwhelm. All my patients know quite a lot
of neuroscience, but do you know, they haven't just had a
(35:15):
blast of it. It's just that they're having an
experience and then we can talk about what's happening with that
experience. And I love it when they're
coming back and they're telling me how they're rewiring things
and they're, they've noticed that, you know, they think that
and this happened and then they believe that and that and oh,
actually, that's not about. Pathological.
(35:38):
Thing that's actually an output that they can learn to problem
solve with and such a good example of it for two patients
just yesterday where they've hadsome really difficult life stuff
come up and then they've told mehow they've been problem solving
based on the the knowledge and the self knowledge that they had
(36:01):
acquired first. And I was blown away with the
self efficacy, you know and thatkind of not going into a
helpless mode, but actually you know why?
Because actually they have been given some information but not
overdosed with it and embedded in the sensory experience that
(36:24):
they are actually having. So then it becomes very
empowering. So you are actually going to be
using your skills, but actually I would say at a higher level
with much more discernment, yes,rather than throwing lots of
stuff in the patient and hoping something sticks.
Yeah, throwing a load of mud at the wall and hoping some of it
(36:45):
sticks, as you say. And I think a great way to test
the success of that approach at the end of the session is to
just gently ask what? What if?
What's been really interesting for you in this session?
Or you could ask what have you learned in this session?
As long as that doesn't feel tooRashid, and I think it's OK if
there's a mildly uncomfortable moment there where the patient,
(37:06):
oh God, I haven't actually noticed anything because to a
certain extent, I think coachingdoes.
It does require your patient to work a little bit harder than
perhaps you're making them work at the moment, but in a very
loving way and for very good reasons in that you want them to
(37:26):
be able to own this process and,and take control of it.
And in my experience, the thing they tell you they've learnt is
often not the thing I thought I was conveying at all, but is
hugely significant to them. You have to be OK with that and,
and go, OK, so and then how might you use that piece of
(37:49):
information? This is a great way to lead into
a home exercise program. How might you use that
information, that thing you've learnt today or that awareness
that you've had? How are you going to apply that
to the situation? And that's, you know, a great
way to check what they've taken away and, and, and how you might
build on that in the future. Well, that kind of relates to
(38:09):
something that something I teachand something I do in my own
practice is usually the last thing that I'll say to someone
is I'm really looking forward tolike hearing, you know, what you
find out between now and the next session.
So they are primed. Primed, yeah.
To be paying attention. So they're not just going away
and going right. I've got to make time for half
(38:30):
an hour of exercise every day. It is literally, what are you
going to find out? And that's when they come back
with the gold. Oh, well, because I can feel my
feet. I notice now that when I go out
for my walk or I notice that when I'm filling up my water
with the the tap with the kettle, I do this funky thing.
(38:52):
I'm like, oh, really? Yeah.
So they said, why do I do that? I'm like, you're obviously
solving a problem somehow, but did you, did you look at whether
there was another possibility? Yes.
And then and So what? This is where some of the ease
starts to come in the session. They start coming back and
telling you, these are the things I found out.
(39:14):
And then that's what you then take as your next.
Yeah, yeah. The funny thing is then is that
I'll, I'll have the clinicians come back and this is like, you
know, when they're on the courses actually identifying a
bit of a sense of unease becausethey say, well, it doesn't feel
like, it feels like the patient's treating themselves.
(39:36):
I don't feel like I'm doing anything.
And it's such an interesting moment to identify when actually
you've set up the conditions fora patient to truly take charge
of the situation, find their owninsights, come back, share those
with you, take that next step. If done, the really important
(40:02):
stuff, the stuff that the evidence says should be what we
do, but you've got. Your A and your P, your analysis
and your plan supported. Absolutely.
But because you haven't done theequivalent of what I the
physiotherapy equivalent of the British lunch box.
Right. So when I Yeah, OK, yeah, we're
(40:22):
pulling from everywhere now. When I first arrived in the UK,
it was 1996 and I went to work in the NHS card of Royal
Infirmary and I had come from five years living in Hawaii and
I'd come from Australia obviously.
So different lunchtime comes andI'm intrigued that everybody has
the same lunch. So they sit down and everyone
(40:44):
has a little box and in the box is a sandwich, a piece of fruit,
a small packet of crisps and a Penguin bar.
And I'm like, everybody's eatingthis and there with like
leftover like, you know, homemade stir fry or whatever.
Everyone's doing the same thing and the physiotherapy equivalent
(41:05):
is it used to be. And now, of course, people have
arguments about it used to be a couple of techniques, you know,
a couple of exercises, You know,it was this little package that
kind of made you feel like I've done a good job.
Because so we are talking about a different model here, but it's
a model we can actually be comfortable with in the context
(41:28):
of the current discussions around evidence.
Because we know that the, the funny little thing that we used
to do, you know, actually isn't the one that has shown to have
massive shifts in, in outcomes. So if, if we can recognize that
and go, oh, actually, instead oftrying to do more of that to get
(41:52):
a different outcome, maybe we could look at this situation
over here where we're still using the skills and dropping
them in. So I still use, do you still use
manual therapy? Yes, I do, but when do I use it?
I use it when we have decided that we want a certain, you
(42:14):
know, to to achieve a certain movement for example, and they
can't get there. Can't feel it?
It's a, you know, it'll be sometimes the the quickest, most
utilitarian little tiny step which is immediately integrated
then into the movement. And what is your experience of
it? And let's explore it and let's
play with it. So I would still use it, but in
(42:37):
it's place it isn't the treatment, it is just a
facilitation of us getting towards a specific objective.
Yeah, it doesn't, doesn't turn it into a passive receiving of
either inflammation or a technique.
It's it's part of that facilitation process.
(42:58):
I was just, I was just thinking whilst listening to you
mindfully. Then Joanne.
So I, my dad growing up for somereason and probably more to do
with his history, absolutely refused ever to give me advice.
I mean, maybe when I was very young he did.
But in my memory of being a teenager and certainly being a
(43:20):
student, I occasionally find myself in a pickle about things
as you do. And if I ever asked him,
invariably his answer was, I don't know, it's your life, do
what you want. Which in a way was empowering.
It was often quite frustrating because sometimes I just
wondered my dad tell me what to do.
(43:41):
Then probably I could blame him for the, but I was brought up
with that. I don't know.
It's your life, you decide. And I'm remembering when I first
realized that I had a coaching approach.
It actually wasn't with patients.
And I'm just thinking about thisbecause so many of our scenarios
(44:01):
today have been a clinician patient.
I really realized that was my preferred way when I started
conducting one to ones with physiotherapists that were
working in our clinic. Because they would be talking
about where their career might be going next, what courses they
might need to do to make sure they got every single patient
ever walked through their door better.
(44:21):
Haha. And invariably what was going
through my head was, I don't know, it's your life.
You're a different person and a different clinician to me.
You need to decide for yourself,and I would find myself asking
questions about all sorts of weird stuff that had nothing to
do with them as a physiotherapist or a clinician
and trying to draw a bit more out of them.
(44:42):
This was way before I I'd eitherreceived coaching myself or
learned about it, but then it just felt like a an intuitive
process. So maybe I need to thank my my
rather stubborn and occasionallydifficult dad for getting me
comfortable with that process, yeah.
Yeah, actually, yeah. Because I had the opposite.
I had a wonderfully engaged, youknow, father, but he was, he was
(45:06):
an advice person. And so, yes, trying to crawl out
from underneath that, but also that gives a bit of a, you know,
insight too. Is that like if someone's giving
you lots of advice, you know, for what you should do, you can
feel the inherent pressure inside if that's not necessarily
a match and, and understanding what that's like on the other
(45:28):
side, when you you know, you know, as a therapist, you're,
you can find yourself in that same and you're, you're doing it
from the best motivations. However, is it best for you long
term to be taking that role? And is it best practice
actually? Is it in the best patients best
(45:49):
interests? And so, yeah, having that, that
flexibility, you know, and it keeps it real, also means that
everyone has the chance to be a lot more transparent, you know,
because people will sometimes come and say, right, you know,
(46:10):
are you going to be able to fix me?
Well, first of all, we're going to have to understand what that
might mean to them, you know, and, and sometimes I've got to
honestly say, look, I, I know wecan be somewhere different to
where we are, but I can't actually say where that's going
to be because we both need to put our feet on this path
together. And we'll, we'll work together
(46:30):
on this to find out, you know, that's, that's the honest truth.
If I'm going to set up going, yes, of course I will be able to
fix you then that's completely unrealistic because that is
something that, well, first of all, as it like as I said, I
don't know what fix means to that person and what they think
(46:51):
fix means at the beginning may be different.
And we all know that scenario too.
The patient comes back. It happened to me last week.
Oh, I'm not any better. Oh, OK, so let's talk about what
you've been doing this week. Well, when we met, you know, we
had show stopping knee pain. We couldn't go up and down the
(47:14):
stairs. We couldn't, you know, we
couldn't do the sport, we couldn't run, we couldn't do, we
couldn't sit down in a chair. So what has actually happened
this week? Oh, well, actually going up and
down the stairs. How's that been?
Oh, not really a big problem. And what else have we done?
Oh, I went for a run. Oh, how was that?
Well, it was OK during it. Bit sore afterwards, though.
OK. And as we've kind of unfolded
(47:36):
it, just like, so how do we feelabout that initial statement if
it's not any better? And he just laughed and went,
yeah, OK, it's actually. And then he brightened up quite
considerably too, because he wasfeeling quite down.
And again, being willing to question because I know what
happened. Otherwise the patient comes
back, says I'm no better and what happens?
(47:59):
Yeah. Change a plan, do something
else, bring another tool there, Yeah.
Absolutely. Let's just settle down and ask a
few more questions. So, Joanne, if people are
listening to this and thinking this sounds great, this sounds
like something I would like in my life, chemical life and
(48:20):
personal life as well. We are going to share some
details, aren't we? Or we've put together a little
slide which I will find some wayto share with this podcast.
I may have already done that by the time this goes out.
Who knows? Jack March, this is your job.
And within that we've got AQR code.
(48:42):
And what we're doing at the moment is we are just collecting
names of people who think this sounds like an interesting idea
and would like to know more whenwe efficiently officially launch
coaching Unpeeled next year. Is that right, Joanne?
Have I set that out correctly? Absolutely, absolutely.
And actually just to to pick up on just what you'd said
(49:04):
previously about, you know, thatthere's feelings about coaching
and how stuff and how, you know,how do we do that?
The really big thing about this is that we have literally peeled
away the things that that you could get confused by or lost by
or anything else and gone. These are the these are the key
(49:27):
things that we got to bring fromcoaching into practice for the
benefits. We've talked about more
sustainable you and for the patient.
And so, you know, we've, we've, we've kind of made it quite a
streamlined kind of workshop, maybe say course workshop,
(49:53):
whatever it is education. So yes, we, we are definitely
just collecting your interests. The date will be available soon.
We'll be doing coming into it early part of next year.
And yeah, you know, I think we both would be really delighted
(50:14):
to be able to share this work. Absolutely.
And it it seems to be a common way that Joanne and I work and
it's very in line with coaching.I think what we're saying is if
you trust us and you're willing to trust the process, then give
us your name, give us your e-mail, and we will walk along
the path with you. That's exactly it.
(50:35):
Exactly it. And possibly ask some questions.
Yes, who knows? Is there anything in can't?
Wait. No, me too.
I'm really excited. It's a lovely thing to look
forward to be doing next year. All right, well, it's a
beautiful day. I'm going to let you go now,
Joanne. I know you've got other things
to go and do this lovely afternoon.
(50:58):
So thank you so much for being awonderful guest.
Again. Really appreciate talking to you
in whatever scenario, but particularly on these podcasts,
it's really valuable. Thank you.
Well, you're welcome and thank you for having me because this
is actually so nice to be able to talk about the real, the real
issues and the real experiences and not be like theoretical
about it. No.
(51:19):
It's a. Wonder pith Talk about the pith.
Yeah, absolutely. Yeah.
And we're going to all get a bitunpeeled.
Reveal the yes. Now we're going to piss off.
Can we finish? Yeah, absolutely brilliant.
Thanks so much, Joe. Pleasure.
Take care Joe Bye. Well, I hope you enjoyed that
(51:44):
conversation and also that it may have whetted your appetite a
little bit more for all things coaching and specifically how
coaching applies to you as a clinician.
If that is the case and you would like to be on the mailing
list to receive more informationabout Coaching Unpeeled as it
unfolds or as it unpeels, then look for the link in the notes.
(52:05):
There's a form you can complete and you'll go straight onto our
mailing list and any informationas it appears will be directly
in your inbox. You'll be first to know.
So it's December and no more youmatters this year.
No more you matters before Christmas.
So if you are someone who is accustomed to being all things
(52:28):
to everybody in all spheres of life, then goodness me, doesn't
December provide some opportunities to exercise that
particular people pleasing muscle?
Why not instead give it a littlebit of a rest?
Why not book in some time, some moments specifically for you,
not just in December? Why not make that a New Year's
(52:49):
resolution? Because you absolutely do bloody
matter. Happy Christmas, Happy New Year.
See you for more episodes in 2025.
(53:14):
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on track. viziohyphenmatters.comMore content than the all you
can eat buffet cart. Hello and welcome to this latest
(00:21):
episode of You Matter. Hello and welcome to You Matter.
In this episode, I welcome back my good friend Joanne Elfenstein
with a very specific remit for this session.
Joanne and I are launching something very exciting in the
(00:43):
New Year called Coaching Unpeeled.
And we are more than aware that coaching has entered not just
the clinical sphere, but seems like, you know, life in general.
Everybody is talking about coaching in different forms and
you may be looking on, you mightbe curious, you may know a bit
about it coaching, maybe you're wondering if this might apply to
(01:06):
you in your life and particularly in your clinical
life. We think it does, but in a very
specific and particular way and that's what coaching Unpeeled is
all about. So we're going to, as is our
usual way, riff on that together, see where the
conversation takes us. But ultimately the aim is to to
(01:27):
tell you a little bit more aboutcoaching unpeeled, what it's
going to look like and, and whether it might be something
that you're interested in. So sit back and just enjoy the
conversation about coaching. And if you're interested in
hearing more about coaching Unpeeled, then we give you some
ideas of how to do that later. And just as a little personal
(01:50):
aside, this is going out on my birthday, December the 8th.
I hope if I got my calculations right as to the launch date of
this episode. So why do I need to tell you
that? Well, happy birthday to me and
what a lovely way to celebrate my birthday to have this episode
with John going out. I hope you enjoy it.
(02:13):
Take care. Don't forget to sign up if you
are interested in coaching Unpeeled and I will back be back
again at the end to remind you of what to do Take care.
Hello and welcome to this next episode of You Matter.
(02:33):
All my episodes are a pleasure, but this is an especially large
pleasure. Especially big pleasure because
I am thrilled to welcome back toYou matter, my good friend and
colleague Joanne Elfenstein. Hello, Joanne.
Hello Joe, it's very exciting for me too.
I had such a lovely time last time I was with you, so I am
(02:56):
looking forward to another beautiful conversation.
Absolutely. So Joanne and I are here for
quite a particular reason together today.
The title of the episode should give you a hint.
Everyone's talking about coaching, and Joanne and I've
been talking about coaching quite a lot because we have
something very exciting launching early next year.
(03:19):
It's coming under the title of Coaching Unpeeled, and that
title should make a little more sense as you listen to our
conversation today. But Joanne, I'm going to hand
over to you and let you explain a little bit about what we are
doing with Coaching Unpeeled. Sure, Joe.
Well, this is just such a lovelyopportunity for us both to do
(03:42):
something we really care about. Joe, I know has the same
motivations as I do for clinician well-being and, and
standards of practice and all those lovely things.
And a lot of people are talking about coaching right now.
And obviously it's something that Joe and I know quite a lot
(04:03):
about because Joe, as you'll be more than familiar with how much
Joe has been doing in the field.Those of you who've trained in
GEMS also know it's been part ofthat for all 20 years or so.
But suddenly it is in the general conversation now and you
might be wondering what it's allabout.
(04:25):
Is it relevant to you? Is it something that would be
helpful in exploring and, and what we've done is taken all of
that experience and a considerable amount of training
and we did it all out to bring it right down to what is going
to be the most powerful and helpful for you in clinical
(04:48):
practice, hence coaching unpeeled.
So yeah, there we go. Yeah, we've we've already given
ourselves the opportunity for loads of references to zest and
pith and even taking the pith out of ourselves.
Occasionally I just think takingthe pith is just gold, yeah.
(05:09):
Yeah, we're going to have. To We're not taking the pith
here. Yeah, exactly.
But yeah, Joanne's absolutely right.
There's a, there's a whole worldof coaching and variations of
coaching approaches, people applying it in all sorts of
different arenas. The thing it reminds me of
actually is when mindfulness started and we all wondered what
it was and was it just for yogisand people that were really into
(05:32):
meditation? And then suddenly there was
mindful walking, mindful talking, mindful playing with
your kids, you know, mindful everything.
And I think coaching is going through a little bit of that
process itself. And many of those things are
really good things. Coaching principles can
absolutely be applied to work and so many areas of life.
(05:56):
But because it's that way, we felt for clinicians, we wanted,
as Joanne says, to really distill it down to demystify
coaching a little bit, but also to make sure that we were
talking about the bits that are really relevant to the clinical
scenario and also really relevant to you as a clinician.
(06:19):
Because we're going to talk in amoment about those two sides of
it. We often go on courses, don't
we? And we're really invested in
what we can learn to better our service for the patient.
And it's not always, it's not always in our mind to consider
how that actually benefits us. But one of the beautiful things
(06:39):
about coaching is that it can bethis two way process.
And yeah, I think that's where alarge part of the value is here,
that yes, you can apply it clinically for your patient, but
it's going to open up so much opportunity, so much freedom,
and I would say from personal experience, so much relief for
yourself as a clinician. Joanne, do you want to speak
(07:03):
about that a little bit more? Yeah, no, absolutely.
So it's it's so interesting because as Joe said, we go on
these courses and we learn techniques to do often to the
patient and that is absolutely not what coaching is about.
With it comes this sense of it is my job to fix the patient.
(07:26):
So the full shouldering of all responsibility, which is heavy
and actually possibly not in thethe patient's best interests and
not in your best interests. So it's interesting because in
this funny binary world we live in, we often assume that if it's
better for the patient, then it's OK that we sacrifice a bit
(07:48):
from ourselves. Or if she we should actually
decide that maybe we should do something that is making our
feeling of being in our job moresustainable, you know, more
enjoyable, heaven forbid, more enjoyable, then somehow we're
taking something away from the patient.
And it's a really interesting little paradoxical feeling that
(08:09):
we have inside about this, that somebody in this interaction is
it's going to cost. And I think the, the joy of
understanding how coaching principles can help you to frame
your clinical interaction, you know, really things that you
(08:29):
will all relate to, like management of expectations.
How many times do collections tell me that they're, they're
thinking that the patient thinksthis or the patient thinks that.
And I'm like, really, how do youknow that?
And then you realize it's a grand assumption based around
anxiety, which is around expectation management.
(08:50):
All of that can be sorted out with some really simple
principles. And that's just one example of
how you can start to ease some of these areas of real tension
for yourself and at the same time really provide some clarity
(09:11):
for the patient and give the patient the opportunity to
really start to step into this with you.
So it isn't you here with all the responsibility, carrying the
patient on your shoulders and then saying, oh, well, the
patient's not taking responsibility.
Well, yeah, of course they're not because you're taking all
the responsibility. You got to create some space for
(09:34):
them to step in. So there's just so many elements
in the clinician experience, youknow, that anxiety, you know,
and that feeling, oh, I didn't get it right, for example, or it
didn't work. OK, we can talk about that a
lot. Whenever someone says, oh, I
tried this, it didn't work. So what does not working mean to
(09:57):
you? And then when we step back and
then look at that again and go, So what did we learn from it?
Instead, the roadblock stops andthe motion gets going again.
So there's just, there's lots ofelements around the, the things
that I know, Joe, you'll be encountering in your coaching
(10:18):
that I encounter my own coachingand my teaching that clinicians
just again and again struggle with and leads them towards
burnout and feelings of not coping and feelings of not being
good enough. So many of these things can be
helped with some really simple principles and some really
(10:40):
simple structural elements that can ease a lot of that.
Yeah. And I wonder if it's worth for
people that haven't experienced coaching at all or either, you
know, received it or had any education, I wonder if it's
worth me just outlining a littlebit about what that structure
(11:00):
is, because I think straight away clinicians listening in
will be able to see how this does apply so beautifully to the
clinical interaction. So partnership is an absolute,
you know, gold standard tenementof coaching.
And to me that's why it's so topical because how many times
do we hear that the modern evidence based way to work with
(11:24):
a client is in partnership to empower your patient to give
them agency. And the way you do that within
coaching is that you begin a session or a, you know, a clinic
session or a coaching pure coaching session with, well, an
agreement comes early, but not right at the beginning.
(11:45):
You can't agree on something until you have learned something
about your patient first. So you come from this place of
curiosity. Your patient turns up that day
with something going on. And it may be something you
already know about because it's not your first session.
Or they may be in an entirely different state to the state
(12:05):
they were in when you met them on their first session.
Whatever you, you start from this place of curiosity.
Where are you at today? And from that interaction
between the two of you, which may involve quite a number of
questions and answers between the two of you, you then get to
the point where you agree together what the end point of
that session is going to be. So that's the first thing that
(12:27):
you, you agree together. And critically, that isn't you
telling the patient it is genuine, genuinely in agreement,
which you couldn't possibly havepredicted beforehand.
This is one of the first places to try and shift, you know, try
not to know, try not to predict.Just allow your patient or your
coaching client to to tell you or to lead you agree with you.
(12:50):
Once you've made that agreement,you then agree how you're going
to get there. And that might be two or three
steps and then you agree where you're going to start.
So I'm not going to give more away than that now, but I hope
people are starting to realize that the reason there's so much
relief around this is you're notactually leading or providing
(13:11):
anything. You are just asking where are
you now? Where do you want to be?
What steps do you think we need to take to get there and where
should we start? And.
That. Covers off quite a few things.
Joe and I had a quick conversation before we pressed
record around the issue of compliance.
(13:32):
I think, Joanne, you said you were actually asked the question
by somebody. Well, how do you, how do you
deal with compliance when you'reusing a coaching approach?
I mean, actually, I hope what I've just described has
illustrated that compliance is implicit within a coaching
approach because the client has LED it.
They have told you what they want to do.
(13:53):
It's come from them. So therefore, you know they they
must be OK with that. Of course, you can record it and
your notes will make that compliance more robust, but
compliance is really implicit inthat process.
Now, there were two things when I started this line of thought.
I was going to say it leads you to compliance.
(14:14):
And the other thing is behaviourchange and adherence to to, you
know, exercise regimes, agreements around what you're
going to do between sessions. You'll see if you start to adopt
this approach with coaching clients or patients that there's
so much more, so much more adherence because it feels
(14:38):
personal. They've, they actually came up
with the solution themselves. They came up with the method
themselves. Therefore, it makes sense to
them why they're doing it, and they really understand what
they're doing because basically they designed the process, not
you. Yeah, You know, it's so true
what you say, Joe, you know, around, you know, the issues of
compliance. As you know, I was saying too
(15:00):
early as someone had asked me like, you know, you know, how do
you manage patient compliance? And and as I said, I was like, I
don't actually have a complianceproblem.
And they were a bit, you know, perplexed by this.
So. Well, yeah, that usually comes
in the same kind of categories. Yes.
But how many reps and sets do you give people?
And the answer is what can be managed in their life.
(15:23):
So I'll give you an example. I've got a lovely patient.
She is right in the maelstrom that some of you might kind of
relate to. She's in her 40s.
She's got three children and a husband.
And there's, like, school runs and activities.
Everything's going everywhere. Her son arrives at the foot of
her bed at 6:20, fully dressed for school and expecting to go.
(15:47):
And and so the the answer to thequestion is, OK, where in your
day do you have a slice of time?And we, we found that the the
time of the day was between 6:00AM and 6:10.
OK. So 6, does that sound feasible
to you that that's manageable? Yeah.
(16:07):
No, it's OK. I'll wake up anyway.
I'm just lying there kind of contemplating how I'm going to
get through the day. OK, then does that sound like a
a good time to be able to commit?
Yes, I'd really like that actually, because I know that
that's time for me to just focuson this before the hurricane
starts. Perfect.
So, So what are we doing there? We're doing what's going to fit
(16:30):
in that time slot. And we've had that agreement.
Now, if she comes back and said I haven't managed to do it, then
we get to find out. And you know, what are your
feelings around that? Well, it could be either.
I just haven't find the motivation.
But that very rarely ever happens.
Usually there might have been other stuff that's come into
(16:51):
life. And once we hear about that,
instead of feeling so down on herself, which is exactly where
she went straight away. So actually, you know, the fact
that you have a mother in hospital with a suddenly
diagnosed terminal illness on top of everything else has
created a bit of, you know, issues with the bandwidth.
And it's OK because, you know, tomorrow's another day.
(17:14):
And so there we go. And so other people will want
more. If we're going to really talk
about patient, like patient autonomy, this is a big one for
me because we're all about, oh, yes, patient autonomy.
But we cannot be saying that while taking all the
responsibility and then dictating what happens.
(17:38):
So if I I have occasionally had,because I tend to work with
people with more chronic and persistent problems, a person
who we've made an agreement and they've come back and not done
it. And really it's just all been
about just not committing to theagreement.
How do I respond to that? Well, I'm going to ask them some
(17:59):
questions around that, but I'm also going to have a very, you
know, this, this is all I have to offer you.
We made an agreement. I can't actually do that.
There's nothing else I can do. How are you choosing to go
forward then? Because it's fine.
But I don't have anything extra.So possibly I'm not the person
(18:21):
for you. And I know people like, you
know, you get the patient go. I'm like, well, yeah, I don't
have a problem with that becauseactually if they don't go away
and reflect and then come back and say, OK, that is an old
pattern and now I get it and I'mready now, great, we move
forward. But what I don't do is put
(18:42):
myself in a situation of continued energy expenditure
over responsible when if I actually honor the fact that
this person is making an autonomous choice, I have given
them the information for them tomake an informed choice.
And if they do not choose that route, they have a right to
(19:05):
that. Yeah.
But that I don't have to keep supporting that when I know that
actually that's not benefiting the patient and it's not my role
to keep facilitating that pattern.
You're so right. I have so many clinicians,
particularly more junior clinicians, come to me.
(19:27):
Maybe we're talking about it a patient they're struggling with
and more often than not there will be this whole list of OK,
they came to me with a shoulder problem.
I tried this exercise, I tried this technique, Then the next
exercise wasn't better. So I tried this, I tried that.
And you're right, the the default is to just keep changing
(19:50):
and keep pulling out something else from the tool kit, not
investigating, as you say, why maybe why a technique didn't
work, but more importantly, why the patient didn't engage in
maybe what you told them to do rather than what you had agreed
to do. And I love lots of things about
(20:10):
that case study you've just shared.
A yes, you got her to recognise the fact that there was 10
minutes in her day. And that's probably the biggest
lesson she took home that day, that, of course, her life.
Felt like this because it was sofull of all the
responsibilities, but also then to realize that that was her
(20:32):
opportunity and it was her choice to take it.
And of course we know that if she chose to take it, that
probably would shift her mindsetand allow her to find other 10
minute slots in her day. But yeah, it's entirely her
choice and it it's not your responsibility or the treating
clinician's responsibility to shift focus just because one
(20:53):
side of the agreement hasn't been upheld.
And that's a thing where, you know, coaching sometimes I think
can have a reputation of being abit nicey, nicey.
And you know, it's partnership is just all about not telling
and being this curious lovely person.
Sometimes it's about being really strong and holding your
line until such time to move on.Absolutely.
(21:17):
I mean, I had a lovely thing come up on recent, you know,
poaching retreat that I just did.
And I was describing this kind of a situation and then someone
said, but don't you feel sad? I'm like, why?
Is it because you could have helped them?
I'm like, I didn't feel sad at all.
And they were, they were a bit perplexed.
(21:39):
And I said, well, if I'm going to honor the fact that this
person is autonomous and they are making a choice, then I
don't have to keep an emotional tie to that, You know it it.
And that doesn't make me a terrible, awful person that I'm
not kind of keeping all these emotional ties.
(22:01):
But I could, I could save them. No, I don't feel sad because I
know I've given that person the best shot I'm able to do.
And maybe someone else will givethem a, a different kind of
thing. And it's OK to.
But I honour her choice and let's go.
Yeah. And then I'm, I'm good with
(22:23):
that. I don't have to carry these.
And we are caring people. And this is again, I think, you
know, I'm sure you come across this to do that conflict between
feeling like you want to be a caring person, what makes me a
good person and having my own boundaries and and also
understanding that other people are making choices and we don't
(22:44):
become better people by taking their choices from them.
And we're going to include that,aren't we, in our course that
self regulation, boundary setting self worth really, which
is a really important part of upholding your part in this
(23:04):
process. And do you find though, like
people, certainly I, I find for myself, but I'm pretty sure you
probably do too, that one of theissues for for clinicians is
often their self worth is taggedto the outcome of the patient.
So your feeling of actual independent self worth is not
independent at all. It's constantly dependent on
(23:26):
other people and actually that that isn't self value.
Yeah, and outcome of a session, outcome of a whole treatment
protocol. So often this is more impure
coaching necessarily than in physio, but I often get the
feedback of fun from the from the client.
(23:47):
Oh my goodness, I had no idea the session was going to go
there. And invariably my response is,
well, I definitely had no idea. And that's the point.
It's it's such a relief to give yourself permission to have no
idea where a session is going togo, but to trust yourself and
(24:07):
the patient that it will go exactly where it needs to.
And so whatever that outcome is,which you can't predict, it's
the right outcome that day and the two of you got there
together and then you'll move onto the next session.
It's, it's such a relief. Well, it.
Is well, it's a relief when we get practiced with it, isn't it?
(24:27):
Because initially it feels really wobbly.
Yes, it's confronting, isn't it,to start with?
Yeah. I mean, remember when we trained
and we got taught that we're writing our notes and at the
bottom was the P for plan for what's going?
To happen. And and you know, I still do a
little pee that sounds a bit weird.
(24:48):
We'll leave incontinence out of that, but we'll but the, the,
the plan I do write some notes for where I think that I think
may be helpful in a subsequent session. 9 times out of 10, none
of that happens exactly the reasons that you've outlined.
But actually by allowing ourselves to respond to what's
(25:10):
really there now in the present,interestingly, although
initially you think that feels abit vulnerable, actually you're
responding to what is real. And you can actually deal with
that instead of trying to squeeze whatever's showing up in
the patient that day into something that's not actually
(25:30):
relevant for them today. And that causes an enormous
amount of stress. Yeah.
But as you say, when we start tokind of go, OK, going to anchor
myself here a little bit and let's respond, Yeah.
Yeah, Listen and respond. Absolutely.
And as you just said, yeah, thatrequires some listening.
(25:52):
And listening's interesting, isn't it?
Listening and hearing being 2 completely different things.
Yeah, listening, waiting to add your wisdom and your reaction is
very different to listening and just allowing yourself to be
present and really hear. And I don't know about you, but
I constantly have to quiet the voice that is going on.
(26:14):
What are you going to say about that?
And oh, what's the next thing? It really takes practice as a
clinician to dull that voice. And when I started coaching
festival, the feedback I constantly got from my non
clinical tutors were you couldn't resist it.
You held off rescuing for about 3/4 of the session.
(26:35):
But there it was every time. When am I going?
When am I going to be able to give up the rescuing?
It is it's implicit. And as you say, we're nice
people. We want to care, but and it
takes time just to relax that rescuing muscle a little bit.
But I think the first time you feel the success of it and you
(26:55):
witness the success of it, it really bolsters you to to try it
again, like any new skill. Yeah.
And absolutely. And when the patient leaves,
because they actually owned thatyou've gone there together.
And again, you know, just so we kind of like nail it down to
something a little bit concrete.It can be something as simple as
(27:16):
you're doing, you know, an exercise or a movement or
whatever. And instead of just teaching,
this is the exercise and then saying you should feel this,
this, and this, which unfortunately for the patient
who doesn't feel that is we're kind of moving into the shaming
inadvertently. But if you're kind of told you
should feel this and you don't, the patient's in this situation.
(27:38):
And then the the therapist starts to go, they start to
power up because we need to makethis happen.
And so now both parties are highly stressed, and the whole
thing can be avoided by saying what's so interesting?
So what do you feel? Oh, OK.
So you feel that instead. So let's let's take something we
all know, a basic bridge. Yeah.
(28:02):
And you're doing this. And in your heart of hearts,
you're hoping that the patient was going to go, oh, I really
feel my glutes. And your patient doesn't.
And hands up, how many people have had that happen to them?
And then we either turn that on ourselves as therapists going Oh
my gosh, it didn't work, you know, or the patient going Oh my
God, it's the same as always. I've seen 5 physiotherapists and
(28:22):
my glutes have never worked and it's just the same again.
So there's something really, really wrong with me because of
course we're over here, there's a physio going or the patient
thinks I'm rubbish because they're not feeling their
glutes. The patient is thinking, the
therapist thinks I'm rubbish because my glutes don't work and
clearly they must do for everybody else.
So you can see where all of thisdialogue is going on between two
(28:46):
people in their own little worlds in that space.
And if we just stepped out and went, what do you feel?
Well, I really feel, you know, my hamstrings.
I'm like, OK, that's really great feedback.
So remember that. Now let's see what happens if we
move your feet a little bit closer towards you.
What happens then? Oh, OK, so that's kind of a
(29:09):
little bit closer towards my hip.
It's still my hamstrings. OK, great feedback.
So now let's just change this thing again.
Now tell me what you noticed there.
And so all the way along, they're actually telling you
their real time experience. Their feedback is as important
as whatever you bring. You're not just trying to fix
(29:31):
it, you're actually saying you're going to bring your
expertise, which is your felt experience.
I'm going to bring mine for how I might actually alternate in
some way. And together we will find our
way to a different outcome, evenif that outcome is this is
actually not the best way forward for you, this exercise.
And that's not a problem. Sometimes we have to step aside
(29:54):
to the side to find something else that the brain can make
sense of. And you've just spoken a little
bit there given to when I wantedto make sure we covered, which
is around this idea of expertisebecause I think people often
hear coaching and think, oh, OK,well, that's just dumbing down.
You know, there's not much evidence base for all the
techniques I've learned. And now this coaching thing's
(30:15):
coming in and it seems like, youknow, I don't need to give any
answers. I don't need to provide any
solutions. I just need to listen and be
present. And, you know, isn't that all
just a bit easy? And I, I like the fact that
there might be a sense of ease around it, but I think it's
really important that we retain our identity as experts.
(30:38):
I don't know what you think, Joanne, but there's, to me,
there's definitely a dance to play between coaching and what
it might be called outside of the clinical world, a dance
between coaching and mentoring, where mentoring is.
You know, I have this experienceof the thing that you're asking
me about. I've, I've walked this past
(30:59):
before and then so I'm going to give you the benefit of my
experience, but I think it's slightly different in the
clinic, clinic clinician patientinteraction in that you did go
to college for three years. You did learn from seniors.
You have done lots of reading, you have done lots of courses
and you've picked up this expertise which the patient is
paying for. But you'll smile, Joanne,
(31:22):
because I, I quote you time and time and time again.
It's one of my favorite things you've ever said to me.
You said coaching or partnershipis not about withholding your
expertise. It's just knowing the exact
point of when to land it. And I love that so much because
to me, that describes this lovely, easeful place of
(31:42):
curiosity. And then it recognizes the point
at which a droplet of expertise will move from a stuck place.
The ideal is the patient has actually asked you for that
piece of information. But let's be honest, they might
not because they might not actually know that that is the
thing in that moment that's going to shift them.
(32:04):
And we are still experts, we arestill clinicians, We still have
the mandate. And in fact, we should deliver
that piece of expertise in the moment.
But the difference is we're not.We're not just firing expertise
at them when you know, for them,it's probably like trying to
drink from a fire hose sometimeswhen a clinician is just firing
(32:25):
all this information and expertise over and over and
over. It's what I love about your,
your, your sentence is, it's this beautiful moment of, Oh
yes, that's just when I needed it.
Not before, not too late, just at the right moment to help us
move on. Well, first of all, I'm grateful
that you actually like can give me my own words back, Joe,
(32:45):
because, because usually someonesays, oh, when you said this,
I'm like, oh, that's quite good.I don't actually have any
regulation. Once it's out of my mouth, it's
gone. So thank you for that.
But yeah, it's super important. I mean, I, I was reflecting on
like even just my patients yesterday, beginning of the
week, I'm like, you know what, Ihad patients yesterday I could
(33:05):
not have treated even a year ago.
And that's after 30 something because, you know, I've kept
developing my expertise. And so we in no way are
undermining that. But as you say, it's, it's about
not actually bludgeoning patients with it when that's not
(33:26):
in, I mean, overdosing. Let's look at broccoli.
OK, Let's just take a complete science step here into the
vegetable world, though. We all know broccoli is good for
us, but it's good for us becauseit's actually mildly toxic and
it stimulates, you know, our systems in order to, you know,
be more robust immunologically. So, but too much broccoli is a
(33:46):
bad thing. You know, just enough broccoli
is good. And it's the same with us
bestowing our, I mean, I say bestowing because that's what
tends to happen. Bestowing and bludgeoning.
There are two things I see. I wrote a piece a while back
saying is in our in our efforts to do patient education, is
there any learning going on? Because we kind of think that if
(34:09):
we just keep talking to someone's prefrontal cortex and
stuffing it full of all our marvellous facts, that somehow
they're going to change. A lot of the time they shut down
because we stuff their prefrontal cortex with all of
that. And then we ask them to feel
something totally different partof the brain.
(34:31):
And we haven't set them up to succeed with that.
And that's when you end up with patients who just learn movement
rules or then they come back andgoing, I haven't been very good
about this or my knees doing that and you know, it's going
nowhere because they haven't felt anything different.
So that's the other thing too, is that all that knowledge that
(34:54):
we have is important for us. We then have to be discerning in
what are the, as you said, the droplets that can land in such a
way without overwhelm. All my patients know quite a lot
of neuroscience, but do you know, they haven't just had a
(35:15):
blast of it. It's just that they're having an
experience and then we can talk about what's happening with that
experience. And I love it when they're
coming back and they're telling me how they're rewiring things
and they're, they've noticed that, you know, they think that
and this happened and then they believe that and that and oh,
actually, that's not about. Pathological.
(35:38):
Thing that's actually an output that they can learn to problem
solve with and such a good example of it for two patients
just yesterday where they've hadsome really difficult life stuff
come up and then they've told mehow they've been problem solving
based on the the knowledge and the self knowledge that they had
(36:01):
acquired first. And I was blown away with the
self efficacy, you know and thatkind of not going into a
helpless mode, but actually you know why?
Because actually they have been given some information but not
overdosed with it and embedded in the sensory experience that
(36:24):
they are actually having. So then it becomes very
empowering. So you are actually going to be
using your skills, but actually I would say at a higher level
with much more discernment, yes,rather than throwing lots of
stuff in the patient and hoping something sticks.
Yeah, throwing a load of mud at the wall and hoping some of it
(36:45):
sticks, as you say. And I think a great way to test
the success of that approach at the end of the session is to
just gently ask what? What if?
What's been really interesting for you in this session?
Or you could ask what have you learned in this session?
As long as that doesn't feel tooRashid, and I think it's OK if
there's a mildly uncomfortable moment there where the patient,
(37:06):
oh God, I haven't actually noticed anything because to a
certain extent, I think coachingdoes.
It does require your patient to work a little bit harder than
perhaps you're making them work at the moment, but in a very
loving way and for very good reasons in that you want them to
(37:26):
be able to own this process and,and take control of it.
And in my experience, the thing they tell you they've learnt is
often not the thing I thought I was conveying at all, but is
hugely significant to them. You have to be OK with that and,
and go, OK, so and then how might you use that piece of
(37:49):
information? This is a great way to lead into
a home exercise program. How might you use that
information, that thing you've learnt today or that awareness
that you've had? How are you going to apply that
to the situation? And that's, you know, a great
way to check what they've taken away and, and, and how you might
build on that in the future. Well, that kind of relates to
(38:09):
something that something I teachand something I do in my own
practice is usually the last thing that I'll say to someone
is I'm really looking forward tolike hearing, you know, what you
find out between now and the next session.
So they are primed. Primed, yeah.
To be paying attention. So they're not just going away
and going right. I've got to make time for half
(38:30):
an hour of exercise every day. It is literally, what are you
going to find out? And that's when they come back
with the gold. Oh, well, because I can feel my
feet. I notice now that when I go out
for my walk or I notice that when I'm filling up my water
with the the tap with the kettle, I do this funky thing.
(38:52):
I'm like, oh, really? Yeah.
So they said, why do I do that? I'm like, you're obviously
solving a problem somehow, but did you, did you look at whether
there was another possibility? Yes.
And then and So what? This is where some of the ease
starts to come in the session. They start coming back and
telling you, these are the things I found out.
(39:14):
And then that's what you then take as your next.
Yeah, yeah. The funny thing is then is that
I'll, I'll have the clinicians come back and this is like, you
know, when they're on the courses actually identifying a
bit of a sense of unease becausethey say, well, it doesn't feel
like, it feels like the patient's treating themselves.
(39:36):
I don't feel like I'm doing anything.
And it's such an interesting moment to identify when actually
you've set up the conditions fora patient to truly take charge
of the situation, find their owninsights, come back, share those
with you, take that next step. If done, the really important
(40:02):
stuff, the stuff that the evidence says should be what we
do, but you've got. Your A and your P, your analysis
and your plan supported. Absolutely.
But because you haven't done theequivalent of what I the
physiotherapy equivalent of the British lunch box.
Right. So when I Yeah, OK, yeah, we're
(40:22):
pulling from everywhere now. When I first arrived in the UK,
it was 1996 and I went to work in the NHS card of Royal
Infirmary and I had come from five years living in Hawaii and
I'd come from Australia obviously.
So different lunchtime comes andI'm intrigued that everybody has
the same lunch. So they sit down and everyone
(40:44):
has a little box and in the box is a sandwich, a piece of fruit,
a small packet of crisps and a Penguin bar.
And I'm like, everybody's eatingthis and there with like
leftover like, you know, homemade stir fry or whatever.
Everyone's doing the same thing and the physiotherapy equivalent
(41:05):
is it used to be. And now, of course, people have
arguments about it used to be a couple of techniques, you know,
a couple of exercises, You know,it was this little package that
kind of made you feel like I've done a good job.
Because so we are talking about a different model here, but it's
a model we can actually be comfortable with in the context
(41:28):
of the current discussions around evidence.
Because we know that the, the funny little thing that we used
to do, you know, actually isn't the one that has shown to have
massive shifts in, in outcomes. So if, if we can recognize that
and go, oh, actually, instead oftrying to do more of that to get
(41:52):
a different outcome, maybe we could look at this situation
over here where we're still using the skills and dropping
them in. So I still use, do you still use
manual therapy? Yes, I do, but when do I use it?
I use it when we have decided that we want a certain, you
(42:14):
know, to to achieve a certain movement for example, and they
can't get there. Can't feel it?
It's a, you know, it'll be sometimes the the quickest, most
utilitarian little tiny step which is immediately integrated
then into the movement. And what is your experience of
it? And let's explore it and let's
play with it. So I would still use it, but in
(42:37):
it's place it isn't the treatment, it is just a
facilitation of us getting towards a specific objective.
Yeah, it doesn't, doesn't turn it into a passive receiving of
either inflammation or a technique.
It's it's part of that facilitation process.
(42:58):
I was just, I was just thinking whilst listening to you
mindfully. Then Joanne.
So I, my dad growing up for somereason and probably more to do
with his history, absolutely refused ever to give me advice.
I mean, maybe when I was very young he did.
But in my memory of being a teenager and certainly being a
(43:20):
student, I occasionally find myself in a pickle about things
as you do. And if I ever asked him,
invariably his answer was, I don't know, it's your life, do
what you want. Which in a way was empowering.
It was often quite frustrating because sometimes I just
wondered my dad tell me what to do.
(43:41):
Then probably I could blame him for the, but I was brought up
with that. I don't know.
It's your life, you decide. And I'm remembering when I first
realized that I had a coaching approach.
It actually wasn't with patients.
And I'm just thinking about thisbecause so many of our scenarios
(44:01):
today have been a clinician patient.
I really realized that was my preferred way when I started
conducting one to ones with physiotherapists that were
working in our clinic. Because they would be talking
about where their career might be going next, what courses they
might need to do to make sure they got every single patient
ever walked through their door better.
(44:21):
Haha. And invariably what was going
through my head was, I don't know, it's your life.
You're a different person and a different clinician to me.
You need to decide for yourself,and I would find myself asking
questions about all sorts of weird stuff that had nothing to
do with them as a physiotherapist or a clinician
and trying to draw a bit more out of them.
(44:42):
This was way before I I'd eitherreceived coaching myself or
learned about it, but then it just felt like a an intuitive
process. So maybe I need to thank my my
rather stubborn and occasionallydifficult dad for getting me
comfortable with that process, yeah.
Yeah, actually, yeah. Because I had the opposite.
I had a wonderfully engaged, youknow, father, but he was, he was
(45:06):
an advice person. And so, yes, trying to crawl out
from underneath that, but also that gives a bit of a, you know,
insight too. Is that like if someone's giving
you lots of advice, you know, for what you should do, you can
feel the inherent pressure inside if that's not necessarily
a match and, and understanding what that's like on the other
(45:28):
side, when you you know, you know, as a therapist, you're,
you can find yourself in that same and you're, you're doing it
from the best motivations. However, is it best for you long
term to be taking that role? And is it best practice
actually? Is it in the best patients best
(45:49):
interests? And so, yeah, having that, that
flexibility, you know, and it keeps it real, also means that
everyone has the chance to be a lot more transparent, you know,
because people will sometimes come and say, right, you know,
(46:10):
are you going to be able to fix me?
Well, first of all, we're going to have to understand what that
might mean to them, you know, and, and sometimes I've got to
honestly say, look, I, I know wecan be somewhere different to
where we are, but I can't actually say where that's going
to be because we both need to put our feet on this path
together. And we'll, we'll work together
(46:30):
on this to find out, you know, that's, that's the honest truth.
If I'm going to set up going, yes, of course I will be able to
fix you then that's completely unrealistic because that is
something that, well, first of all, as it like as I said, I
don't know what fix means to that person and what they think
(46:51):
fix means at the beginning may be different.
And we all know that scenario too.
The patient comes back. It happened to me last week.
Oh, I'm not any better. Oh, OK, so let's talk about what
you've been doing this week. Well, when we met, you know, we
had show stopping knee pain. We couldn't go up and down the
(47:14):
stairs. We couldn't, you know, we
couldn't do the sport, we couldn't run, we couldn't do, we
couldn't sit down in a chair. So what has actually happened
this week? Oh, well, actually going up and
down the stairs. How's that been?
Oh, not really a big problem. And what else have we done?
Oh, I went for a run. Oh, how was that?
Well, it was OK during it. Bit sore afterwards, though.
OK. And as we've kind of unfolded
(47:36):
it, just like, so how do we feelabout that initial statement if
it's not any better? And he just laughed and went,
yeah, OK, it's actually. And then he brightened up quite
considerably too, because he wasfeeling quite down.
And again, being willing to question because I know what
happened. Otherwise the patient comes
back, says I'm no better and what happens?
(47:59):
Yeah. Change a plan, do something
else, bring another tool there, Yeah.
Absolutely. Let's just settle down and ask a
few more questions. So, Joanne, if people are
listening to this and thinking this sounds great, this sounds
like something I would like in my life, chemical life and
(48:20):
personal life as well. We are going to share some
details, aren't we? Or we've put together a little
slide which I will find some wayto share with this podcast.
I may have already done that by the time this goes out.
Who knows? Jack March, this is your job.
And within that we've got AQR code.
(48:42):
And what we're doing at the moment is we are just collecting
names of people who think this sounds like an interesting idea
and would like to know more whenwe efficiently officially launch
coaching Unpeeled next year. Is that right, Joanne?
Have I set that out correctly? Absolutely, absolutely.
And actually just to to pick up on just what you'd said
(49:04):
previously about, you know, thatthere's feelings about coaching
and how stuff and how, you know,how do we do that?
The really big thing about this is that we have literally peeled
away the things that that you could get confused by or lost by
or anything else and gone. These are the these are the key
(49:27):
things that we got to bring fromcoaching into practice for the
benefits. We've talked about more
sustainable you and for the patient.
And so, you know, we've, we've, we've kind of made it quite a
streamlined kind of workshop, maybe say course workshop,
(49:53):
whatever it is education. So yes, we, we are definitely
just collecting your interests. The date will be available soon.
We'll be doing coming into it early part of next year.
And yeah, you know, I think we both would be really delighted
(50:14):
to be able to share this work. Absolutely.
And it it seems to be a common way that Joanne and I work and
it's very in line with coaching.I think what we're saying is if
you trust us and you're willing to trust the process, then give
us your name, give us your e-mail, and we will walk along
the path with you. That's exactly it.
(50:35):
Exactly it. And possibly ask some questions.
Yes, who knows? Is there anything in can't?
Wait. No, me too.
I'm really excited. It's a lovely thing to look
forward to be doing next year. All right, well, it's a
beautiful day. I'm going to let you go now,
Joanne. I know you've got other things
to go and do this lovely afternoon.
(50:58):
So thank you so much for being awonderful guest.
Again. Really appreciate talking to you
in whatever scenario, but particularly on these podcasts,
it's really valuable. Thank you.
Well, you're welcome and thank you for having me because this
is actually so nice to be able to talk about the real, the real
issues and the real experiences and not be like theoretical
about it. No.
(51:19):
It's a. Wonder pith Talk about the pith.
Yeah, absolutely. Yeah.
And we're going to all get a bitunpeeled.
Reveal the yes. Now we're going to piss off.
Can we finish? Yeah, absolutely brilliant.
Thanks so much, Joe. Pleasure.
Take care Joe Bye. Well, I hope you enjoyed that
(51:44):
conversation and also that it may have whetted your appetite a
little bit more for all things coaching and specifically how
coaching applies to you as a clinician.
If that is the case and you would like to be on the mailing
list to receive more informationabout Coaching Unpeeled as it
unfolds or as it unpeels, then look for the link in the notes.
(52:05):
There's a form you can complete and you'll go straight onto our
mailing list and any informationas it appears will be directly
in your inbox. You'll be first to know.
So it's December and no more youmatters this year.
No more you matters before Christmas.
So if you are someone who is accustomed to being all things
(52:28):
to everybody in all spheres of life, then goodness me, doesn't
December provide some opportunities to exercise that
particular people pleasing muscle?
Why not instead give it a littlebit of a rest?
Why not book in some time, some moments specifically for you,
not just in December? Why not make that a New Year's
(52:49):
resolution? Because you absolutely do bloody
matter. Happy Christmas, Happy New Year.
See you for more episodes in 2025.
(53:14):
Are you tired of stick people drawing stinking up your
exercise programs? Do you wish you had an exercise
prescription software that had hundreds of pictures, videos,
fully customisable text, inbuiltvirtual consultation software
and you could send it by e-mail or WhatsApp?
If that software exists, I bet you'd want a three month free
trial, wouldn't you? Just go to
rehabmypatient.com/physio Matters now.
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