Physio & PTSD

[Ptsdflo]

Hi, I'm new to here & would really appreciate some advice (sorry for long post). I am currently seeing a physiotherapist for some chronic health conditions. However found some of the aspects of physio triggering. On the 2nd session I was honest with the physio & explained I had PTSD & some parts of physio were causing me anxiety. Initially she seemed understanding & tried to ask me what the cause of PTSD was to have an understanding of how she could help. As I was not yet ready to answer such a difficult question I couldn't answer her so she left it at that. By the 3rd session I realised I would have to explain a little more but as I was worried of it being shared with just any other health professional I asked her if it was confidential just to physio. She responded that it was however if she was concerned she had a duty to report her concern etc but what then threw me was she finished her sentence with "don't tell me, It's ok I don't really need to know". This made me feel so uncomfortable & like she wasn't interested to take the time to understand how It was making me feel. We then proceeded with the physio session & she did not change any aspect (still asked me to do an exercise I found triggering & said "just don't think about it"). Clearly she has never dealt with a trauma patient before & is inexperienced in how to handle it but expected a little more understanding. I'm not able to change physios ( it would also mean explaining everything again causing more distress) & she is otherwise very good physio side of things. My question is how do I now approach her to explain she needs to adapt some things & why explaining a little more about the cause for her to understand?

[Blueruth]

It does sound like it is not something she is used to and may not even be trained for it. So what if you start there? You are uncomfortable. She is uncomfortable. You have that in common. Is it understandable that she may not have all the knowledge but she can learn? Help her help you.

[Ptsdflo in reply to Blueruth]

I would like to do this but as she kind of shut me down by saying "don't tell me about it" It's difficult to know how to then bring it up again with her.

[Blueruth in reply to Ptsdflo]

She needs to know what exercises are not good. She doesn’t need to know everything but you two need to discuss boundaries… by that I mean the type of exercise that is causing you problems and which ones you can’t “push through “ and which ones you can. The best time is at the beginning of the session so the air can be cleared and you can focus without distraction.

She may have said that because she is afraid of getting into territory that is beyond the scope of treatment. You asked about confidentiality. In PT confidentiality isn’t a big concern typically. So maybe ease her mind. Keep the discussion focused on what works and what doesn’t work for the pt. I assume this is past trauma, not currently happening so nobody is currently harming anyone. That is probably her concern.

[Ptsdflo in reply to Blueruth]

Thank you that has really helped. I also didn't think about the confidentiality in this way and makes sense as she was going on about duty of reporting which is not an issue as like you said it's a past trauma not current.

[blackcat64013]

Hi & thank you for your post. 👍Blueruth is on the right track. You both need to be on the same page.

Trauma informed care (TIC) is a relatively new concept in the practise of health care, Perhaps even more so for allied health professionals e.g. physics.

Person centred care is not.

Perhaps you could download some TIC information + physiotherapy and use it as the basis for your chat with the physio.

If you are up for it, you might like to bring the situation to the physiotherapy association as a learning tool from your lived experience 🤔

All the best 🦘

[Ptsdflo in reply to blackcat64013]

Yes in the UK I don't think physios are really trained about trauma informed care.

[Kainan]

It’s not really a part of her job to accommodate that for you. I think she was trying to make you feel comfortable by saying she doesn’t need to know. Unless it’s a serious medical emergency, that is not the place to bring it up

[bethelbee in reply to Kainan]

Any healthcare provider should do what they need to do to make you comfortable and be accommodating. That therapist may not need to know exactly what happened but should try and be more understanding that something did happen and certain exercises make her feel uncomfortable. It was rude of her to tell her to not think about what happened, that's invalidating her feelings. I worked in healthcare for almost 40 years.

[Ptsdflo in reply to Kainan]

Thanks for your reply. Slightly disagree as one of the injuries she is treating relates directly to it & how can she treat effectively if she doesn't know at least basic facts & to not retraumatize a patient.

[Kainan in reply to Ptsdflo]

You can bring up your concerns, but it should fit the scope of physical therapy. If a past trauma has triggered fear about doing therapy, then that’s another issue that needs to be addressed outside of physical therapy. But if it’s regarding a specific exercise, her job is to tailor that exercise to meet your current abilities and specific goals without you incurring further injury

[compasnet]

Tell her when YOU are ready not when SHE is ready, uou,"ll.share what is comfortable to YOU!

[Ptsdflo in reply to compasnet]

I totally agree with this but unfortunately she completely shut me down when trying to explain to her.

[compasnet in reply to Ptsdflo]

I'm so sorry Ptsdflo I hope thing's get better. 🙏

[Ptsdflo in reply to compasnet]

Thank you

[compasnet in reply to Ptsdflo]

You're welcome. In my humble opinion, maybe beig more assertive and expressing your frustration and disappointment is in order now?

[akbj]

Hi, Not sure if I can give you advice about this but can relate an experience I had with a physical therapist, I have chronic pain for many years & something worse happened a few years ago that caused me to barely be able to walk, & I live alone with no vehicle so this made things difficult. I did manage to get to PT & was extremely depressed in addition to the physical stuff. The pain was severe & I was just in a super low place so one day I called in to cancel that appt which I'd never done before. The PT called to ask how I was doing which was kind of her but I said something really stupid re my state of mind & how I was thinking of doing something extreme. I was mostly venting but she said she needed to have me go to an ER. Or she would send the police to come do a welfare check. I wouldn't promise her to go to the ER, I just wanted to lie down & sleep but a little while later there was a knock & there were 2 policemen at my door. I was so freaked out & afraid. They said I needed to go to the ER & they could take me. I didn't feel up to arguing about it so went with them. One of the hospitals in my city has an actual psych ER dept but I just told them I could go to the other hospital because it's closer & I just wanted to get it over with. Our city has a crisis team now to respond to mental health calls but they didn't respond to this call. The officers were really brusque & kind of rude to me, when we got there they dropped me off, I nearly fell getting out of the car & they just drove off. I went in & checked in & had the worst experience there. It was awful. I said what I knew they needed to hear & was able to leave late just in time to catch the late bus home. No one walked me out or anything. I was crying when I left. The psych Dr I spoke with was a telemed dr on a screen. (this was before covid) Anyway, I realized the PT place kind of had to do what they did for liability reasons but it was a really awful experience that made me feel even worse. I hope you're able to find a way to deal with your situation.

[Ptsdflo in reply to akbj]

That sounds awful I'm sorry you had to go through that. I think part of the problem with the PT is combo of time constraint (so not able to adapt things for me or give me a moment if I'm struggling) as well as her feeling uncomfortable with the situation (which then makes me uncomfortable). It's important I continue to but it's making me nervous to go, so don't know after the comment she made whether I should just be more blunt with her.

[C10davis]

My mom has PMR and the doctor suggested physiotherapy. At first, I'm not sure why he suggested physiotherapy and I always doubted what physios can do about PMR. I did ask the physio about this and he said that - physical therapy can be incorporated as a valuable component of a therapeutic regimen to reduce the risk of early functional impairment and severe disability. He recommended a combination of exercise therapy and education in the treatment.

I figured that having a good understanding between the patient and doctor is necessary. If you don't know the procedure and what is it for, you can completely co-operate with the practitioner. Ask your physio about the procedure and tell him/her your concerns. I'm sure this will help you alot.

[NickieLane]

I’m pretty new myself and I’ve talked about my PTSD, Depression and Anxiety and a whole lot more. I can tell you that I got better results on this website than I ever have when I talk to my psych, Everyone here is very supportive and gives great advice. What I’m getting at is don’t hesitate or feel embarrassed to say whatever you need to get off your chest because I promise you people can definitely relate and give great advice because they might have been through the same thing or something similar. Some doctors never suffered PTSD. Depression. Anxiety attacks. They only know the text book term. Some of the best advice is the feedback from others who have suffered from the same thing on this website.