Incorporating Awe in Physical Therapy Sessions

Dr. April Dominick // #ICEPelvic // www.ptonice.com 

In today's episode of the PT on ICE Daily Show, #ICEPelvic faculty member April Dominick unpacks the one emotion you are underutilizing during client sessions: “Awe”. In this episode, she defines awe, discusses benefits of experiencing awe both as a provider and client and gives examples of how to spark awe during PT sessions.

Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog.

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EPISODE TRANSCRIPTION

INTRODUCTION Hey everyone, this is Alan. Chief Operating Officer here at ICE. Before we get started with today’s episode, I want to talk to you about VersaLifts. Today’s episode is brought to you by VersaLifts. Best known for their heel lift shoe inserts, VersaLifts has been a leading innovator in bringing simple but highly effective rehab tools to the market. If you have clients with stiff ankles, Achilles tendinopathy, or basic skeletal structure limitations keeping them from squatting with proper form and good depth, a little heel lift can make a huge difference. VersaLifts heel lifts are available in three different sizes and all of them add an additional half inch of drop to any training shoe, helping athletes squat deeper with better form. Visit www.vlifts.com/icephysio or click the link in today’s show notes to get your VersaLifts today. APRIL DOMINICK What is up everyone? Happy holidays and welcome to the PT on an ice daily show. My name is Dr. April Dominic. I am with the pelvic faculty today. I'm hopping on to talk about the craft of sparking awe via PT. So what is awe? We'll talk about what it is. We'll talk about the benefits, and then I'll give you some examples of how to spark awe during your physical therapy sessions.

DEFINING AWE First off, let's define it. Researchers define awe as the feeling that occurs when you encounter something unexpected, something vast, something extraordinary. And this emotion awe can come across the gamut of types of emotions. It can be positive in the sense of inducing pleasure. It can be neutral in the sense of inducing connection. and it can be negative in the sense of having some sort of uncertainty about it. With awe, what it tends to do is it diminishes the focus on the self and instead reflects it to the collective. So folks tend to be a little more concerned about others, about the grand scheme, about the collective versus themselves. And often people think of awe as if it's this vast, physical, massive thing that has to happen, like seeing the view of earth from space. It can actually be that, but also be something a little smaller or a little more emotionally dense. Some examples of awe, there are so many, we'll go through a few. Awe can be the emotion that's emitted when an orchestra finally reaches that crescendo during a long drawn-out musical phrase. It can also be something very impactful from a social perspective, such as, do y'all remember when we used to clap for the healthcare workers during quarantine around 8 p.m. That was something that was happening across the world that was just very unison in nature. And it can be the sting of a slam dunk of the opposing team with two seconds to go, resulting in a loss during a basketball game. I have a few instances of awe that I'm reflecting on from my personal life, Uh, and one is a couple of years ago, I had the opportunity to say goodbye to my friend from physical therapy school just three hours before she died. And that was a very powerful, impactful way of feeling off for myself in contrast with a very natural, big phenomenon that I got to experience this past year. I was in Iceland chasing the Northern lights. And I just wasn't successful with that. I finally came home and, uh, draw drew the curtains on my Airbnb just one more time at 2 a.m. And lo and behold, above me was this incredible, incredible feat of nature of dancing Northern lights, just neon greens and soft pinks. So vibrant right over my Airbnb. And it was, it was just so incredible. And then it can be something smaller. Like yesterday I was taking a walk in the Texas Hill Country neighborhood and I looked up and across from me just yards away were two brown and white stags just majestic and staring at one another. So those are some examples of awe. They can be big, they can be small.

THE PURPOSE OF AWE And what is the purpose of awe? The purpose is to pause. It's to allows time to slow down and to allow us to reflect on understanding an event that just happened to us. So how do we express awe? I want you to know how we express awe so that you can identify it during your physical therapy sessions. We do so via language. Wow. Ooh. Or some might say, oh, that was awesome. or I'm awestruck. We do so with verbalization of wonder. We may, after witnessing an incredible event or listening to a heartwarming story of one of our clients saying, I was finally able to lift my grandkid after having shoulder surgery and I did it with no pain. We may express awe via emotions. It can be tons of tears or, um, laughter or goosebumps even. And we also do so via facial expressions. So it might be a jaw drop or eyes widening. Eyebrows lifting, these are all things you may encounter, see folks do in your physical therapy sessions. And that is something that you can do as well with your own expressions and reactions to them. According to the research team Cohen et al, awe is a universal expression that is distinct from 50 other emotions. And it is also present across 144 different cultures. They, in one study, they looked at 2 million videos of people watching fireworks and individuals seem to express awe in similar forms.

THE BENEFITS OF AWE So why is awe beneficial? There are so many benefits to the emotion awe. Mentally, it induces a sense of calm. It reduces anxiety and depression. And per researcher, Dr. Keltner, he has suggested that awe also has a role in the grieving process. This can be grieving of a human, of a pet, or even of a body part, if someone's had an injury or a surgery, or maybe even time, thinking of the postpartum individual who may be grieving her pre-partum self. Physically, awe can show up and it's beneficial from a physical sense in terms of it dials down the fight or flight response. It can increase cardiovascular health and longevity. And then on a transcendental level, the emotion awe helps us feel part of something larger than ourselves. We think of this from our clients perspective in the sense of some of our clients come in and they let their diagnosis just identify them, right? They come in and they're like, well, my fibromyalgia, yada, yada, yada. Right. And they are just blaming everything and, and saying that their existence is due to fibromyalgia. and that is going to get them to perseverate on their injury or their condition. Awe or practicing awe would be an awesome thing for them to do just so that they can kind of step out, zoom out and look at the collective and take the instance of focusing on their own injury or condition away. We can also think about it from what we do on a day to day. We are sitting there listening and working with all different kinds of individuals right then and there. We as clinicians are practicing awe as well as we're focusing on others, not ourselves. And I think that this can maybe even help us with our burnout in our profession. Just remembering and reflecting on those instances of awe.

HOW TO SPARK AWE So let's discuss how we can spark awe in our PT sessions through our environment and through our interactions. From the environment standpoint, awe can be induced by just even the music that you're playing. Music has an incredible power in the sense that sound waves activate the vagus nerve. It activates our dopamine a regulation or reward system. It lowers cortisol. So just by turning on music that brings you or inspires all in you or asking the client, Hey, what kind of tunes can I put on for you? And then decorating your clinic with maybe pictures or, um, pieces that represent bring us like, uh, photos of scenes from your travels or photos of your pets, your family, your dogs, all of that can induce awe and help in the client environment overall. And then finally, interactions that we have in our PT sessions via assessments and treatments. I've got a few here. So the first, we can inspire awe by our reactions during session, whether that's a concerned jaw drop or those widened eyes or even dropping a verbal phrase for the client. Since they've said, oh my gosh, I've just started exercising so much now, my frequency has increased. I went and bought that 50 pound kettlebell that you suggested and we can give them praise. and inspire awe in that way. Also, we can use our senses as a gateway to experiencing or expressing awe. With the exception of taste, we tend to utilize all of our senses in our PT sessions. Hearing, we actively are listening to our clients as they share their stories. sight, we're watching them and helping and suggesting different movement patterns for them. We are touching them via palpation, via assessment, via our manual therapy skills. And smell, that may be just for our wound care colleagues. And then in terms of treatments for patients, you can suggest all practices, We can play games during our sessions or encourage them to play games. This is going to ignite that childhood sense of wonder. Every time I think of sense of wonder, I'm thinking of Leanne Ryan's, I Hope You Dance or Leanne Womack. It might be Leanne Womack. She says at the very beginning of her song, I hope you never lose your sense of wonder. And then another lyric is, I hope you still feel small when you stand beside the ocean. All of that reminds me of awe and wonder. So we can tap into our childhood feelings of discovery with our clients and encourage them to do so as well. And then we can suggest all walks. This is something where, you know, maybe we're doing fitness outside of the clinic or we're asking them to do their rehab emoms outside because maybe they'll hear the birds chirping, cute birds chirping, or maybe they'll see a new bloom in their garden from a flower. just different ways to bring out awe. And then we can also use awe as a meditation or mindfulness supplement. In case you want any other resources or you want to dive deeper into the research on awe, check out Dr. Keltner's book on awe, the new science of everyday wonder and how it can transform your life. So to sum up today, we can't all fly to space and take a bird's eye view of earth to experience awe, but there is everyday awe around us, even in the clinic. Awe is an emotion that's extraordinary. It removes focus from the self. and transfers it towards the collective from an emotional bit standpoint, like supporting a client's aha moment when they're saying, Oh my gosh, I think my pelvic pain and my urinary urgency are related to that episode of abuse that I had. Or when a, when we as a PT break down a client's thought virus that they think lifting heavy will result in injury. And then in that very same session, both the client and ourselves experience awe when that client cranks out 12 deadlifts at 80% one rep max, feeling no pain. And they thought they'd never be able to do this because of their bum knee. Awe is perceptible in each of your PT sessions, whether it's with a new client or with someone you've seen for years. Remember, how do we increase awe? We can do so through increasing our own awareness of all happening throughout our sessions. We can do so through facial expressions, watching someone's body language, through the words we say. And remember to use your senses. And we also can encourage folks to utilize awe and seek and appreciate awe inside and outside the clinic. This is all going to help with increasing their mental and physical well-being. So I'm faculty with the Pelvic Division here at ICE, and we have so many offerings that we'd love to see you get some awestruck education with. We've got our weekend live courses starting January 13th and 14th in Raleigh, North Carolina, and January 27th and 28th in Hendersonville, Tennessee. We'd love to see you live or at any of our online offerings, head to beauty on ice.com to check those out. I hope y'all have a wonderful holiday and experience large doses of awe this week. And as you ring in the new year with those fireworks display, know that folks all over the world are expressing similar instances of awe, just like you take care y'all.

OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.