Thursday, June 20, 2013

Shades of "can't"

Physical therapy is very... Oh, there doesn't seem to be one word. "Interesting," I guess, "challenging" it's of course supposed to be, "enjoyable" sometimes... but only sometimes. Sometimes it's very deeply wounding.

Part of the genius of these physical therapist's approach is to exercise specific muscles. Here, we're working a hip adductor, now we're working a hip abductor. They're a big Pilates house, they love working the core. And that's good!

But the specificity of their approach to individual muscles is also very, very, very specifically illuminating where my nervous system doesn't work. Because there are things that I just can't do, because my brain may request a muscle to move, but the message isn't getting through.

There's also some dissonance between me and the therapist's approach to the word "can't." Now, I know they're trying to keep spirits up, keep a positive approach, "perhaps what we're doing today is forging new connections which will enable you to do 'old' things in 'new' ways," and all of that "encouraging" stuff.

Well, here's the thing. I've been a musician all my life, and I have been a vocalist, a trombone-and-related-instruments brass player, an organist, a conductor, and a percussionist who yes had lessons (and very good ones) but I worked my ass off teaching myself to play timpani, snare drum (several styles), mallet percussion (especially xylophone and glockenspiel), and drum set: jazz (big band and small combo), a little bit of funk/fusion, and of course "generic Christian rock," as one of my friends described it. And oh yeah, kyudo. Which, oddly enough, is "spiritually" the same as the way I learned percussion (but that's definitely another story). I had to understand the magical "moves" of famous card magician Larry Jennings to document them. And they were not easy. I've done all sorts of amazing "physical doing" stuff.

But to return to the physical therapy discussion, I have very profound and very personal awareness of the different kinds of "can't."

  • I can't because I don't understand how (especially "how to start"). Once I understand it, I'll probably be able to do it, or at least to work on it.
  • I can't now, but I will eventually be able to. Maybe sooner, maybe later, but "can" is definitely gonna happen.
  • I can't now, and I'll eventually be able to sort-of do it, but it's not my "thing" and there's only so good that I'll ever be with this, so let's work on something else and come back to this later. (Percussionists are called upon to play everything, but they always find that they're more comfortable/good at certain instruments, so those become "their thing." One fellow is good at everything, but BOY is he good at drum set, so that's what I'd call him for. Another one is good at everything, but BOY is he good at timpani, so that's what I'd call him for.)
  • I can't now and I don't want to. Can/can't aside, this thing (whatever it is) just pisses me off. (Sometimes that can be modified into "but I can do it anyway," but sometimes it just pisses me off and I don't need to live in "can't" and "angry."

For all of these, attitude can make a huge difference. Attitude is huge in converting "can't" to "can." Sometimes it's one of the prime components in the conversion of "can't" to "can."

But what I'm called upon to do in physical therapy is different, because of the state of my nervous system. "Move your leg there," the therapist asks. Nope. Ain't gonna happen. I'm doing the "trying" in as many ways as I can, and yeah maybe there's a way to "try" that I haven't found yet (and of course it's still worth trying said "new ways"), but were' talking about a different kind of "can't" here. It's "can't" and no qualifiers... just "can't."

Now yeah, I know that the nervous system is inherently self-correcting/constantly adapting, that damage can be "worked around" and all that. And I know that claiming "I can't" as a forever-o-Lord-thy-word-is-settled-in-Heaven permanent "given" is not therapeutically wise or desirable. And honestly, I'm not in that space, and it's correct for the therapists to steer me away from it.
But goddam it, when I say "I can't," it means that I can't. Here and now, whatever it is, I can't.

And the specificity of the physical therapy to address specific muscles in specific ways is forces me into a face-plant into "I can't."

And for all the help that I want to tell myself that it's doing for me, and for all the help that I can feel it's (sometimes) doing for me... I leave my physical therapy sessions subtly but profoundly, and deeply, wounded.

Haven't yet figured out how not to suffer like this. Hope I will sooner than later.

And, you'll notice, I didn't say "I can't figure out how." Because I really, really understand the shadings of "can't."

Except this one, I guess.


Muffie said...

I did many different rounds of PT, at different places. One was part of a huge complex, and the therapists were excellently trained to do their work. The guy I had was patient but persistent -- he wouldn't accept "can't" either. But he knew my limitations and worked around them. I stayed there until I fell on a cracked concrete pavement while leaving. I was too bruised for several weeks.
The other place, closer to my home, used different methods, but worked toward the same goals. I stayed there until I honestly couldn't progress beyond where I was.
Both times, I know I worked my butt off, but I rarely saw much improvement, and that discouraged me.

Good luck with your program -- I wish you much success. AND you've given me an idea for a post!!


Anonymous said...

Good post. I've thought a lot about this, especially after my last PT appointment. I left wondering what it's like for the therapists when they are so limited in how we can be helped....and I wondered that because, unlike other times, there was no talk about another appointment. I think her ideas were exhausted, and I was exhausted-the combination left us with nowhere to go. It has helped me in the past. I hope you were given something to do that isn't insurmountable.