Coping with feelings

In the third of our series for physios planning their CPD, Robert Millett feels the effects of empathy

Observing people in physical or emotional pain is par for the course in the health service. As a clinician, how does this barrage of human suffering make you feel? And how do you process what you’re feeling?

Being consciously aware of your response to a patient is part of what has become known as ‘emotional intelligence’.

This can be loosely defined as an ability to monitor one’s own and others’ emotions in an uncritical, self-aware manner that allows for a choice of response. 

Many physios have this understanding and sensitivity, either developed intuitively or learnt through experience. But it is also a talent that can be consciously cultivated and improved upon.

Digital storytelling

Ann Childs, a physiotherapy lecturer at University of Nottingham, uses ‘digital storytelling’ as a tool to stimulate emotional intelligence and encourage reflective learning in the physio students who attend her mental health module.

Digital storytelling is the name given to short films that often convey a highly emotive personal narrative. In Ann’s class, the DVDs feature service users who share their challenging life experiences and speak about how physiotherapy has aided their recovery. Digital storytelling does not attempt to justify or explain any meaning behind each story. There are no introductions or conclusions; the clips are simply ‘snapshots’ of moments in a life and encourage reflection by the viewer.

‘These real-life stories are powerful teaching tools,’ says Ann. ‘As clinicians we are focused on the physical, which is understandably prioritised in student learning. Yet to be aware of psychosocial issues, and respond to them sensitively and appropriately, with compassion, is crucial to effective quality treatment.’

Students have told her that the insights they gain enhance their knowledge, allow deeper understanding and help them see things from the patient’s perspective. One called it ‘the most important part of the module’. Another said ‘It changed my whole way of treating patients.’

Physio student Sarah Macknally recently learned an important lesson from a digital story in one of Ann’s classes. ‘The clip taught me that trust in patients is one of the most important qualities I can have as a healthcare professional,’ she said.

Experience digital storytelling at:

Advantages for health

The benefits of fostering emotional intelligence in clinical practice are starting to be acknowledged. A recent report from the NHS Confederation, ‘Feeling better?’, linked patients’ experiences with their long-term health and levels of efficacy (see ‘Happy patients mean better success rates, Frontline, 19 January 2011). It showed that factors such as interpersonal awareness and empathy have a real impact.

Jo Webber, the confederation’s deputy director of policy, explains that simple things — ‘like spending time with patients and listening to their concerns’  produces good results. But it’s not just service users who can benefit: physios can too.

Clinicians are better able to manage stress if they can understand the feelings they experience in response to service users and workplace issues. A key benefit of bolstering emotional intelligence could be its potential to reduce cases of burn-out.

Traditionally, clinicians have considered it unprofessional to become emotionally involved. Added to this is the sheer number of patients they encounter, which inevitably raises the risk of inducing ‘compassion fatigue’. Amid the daily rush and routine, feelings that would normally arise often become blocked off from conscious awareness. In the long term, there is a danger that these unprocessed emotions could contribute to burn-out.

‘When people are stressed, as most of our physio staff are, they haven’t got the emotional capacity to process their feelings and respond to them appropriately,’ says Ann. ‘They can’t take on any more and basically have a safety valve that shuts.’

Developing mindfulness

  • One way of countering stress or shut-off is to practice a form of ‘mindfulness’.
  • Observe what is happening in your body.  For example, are your shoulders tense?  
  • Notice your corresponding thoughts and feelings. Are you irritated, or nervous?
  • This ‘felt awareness’ provides a detached, uncritical way of noticing your physical responses to other people and situations.
  • The opportunity then arises to reflect upon the meaning behind your reaction.

Ann Child offers some learning tips: 

  • Listen to people, while watching TV or sitting in a cafe, and try to identify the essence of what they are saying.
  • Don’t listen to words or content — listen to the feelings. It might be very different.
  • What is the person actually expressing?
  • Then focus on yourself and see where you are feeling this in your body — in your stomach, or your head, or your neck?
  • Ask yourself ‘Am I responding in an angry way, in a protective way or an empathic way? And why is that?’

How to use this article towards your CPD

  • Keep a journal for at least a couple of weeks, making a note of your emotional responses to specific situations and people.
  • Be sure to record events that made you feel good as well as those that made you feel angry and upset.
  • If time to log the information is tight, you might find it helpful to use emoticons to summarise how you felt about a particular situation.
  • Once you have recorded this information, make some space to read back through your entries.
  • Pay attention to your emotional reactions to specific people, places and events.

Start asking questions

  • Why did I respond in that way?
  • How could I have reacted differently?
  • Once you have analysed a few journal entries, ask yourself whether you can see any patterns of behaviour emerging.
  • Do specific people help you calm yourself?
  • Are there particular types of situations that you find make you feel angry?
  • Does the time of day or place have an effect on how you react? 
  • Use this information to become aware of your ‘buttons’, the things that make you  immediately feel angry or upset.
  • Think about ways in which you could learn to deal with them.
  • Pay attention to strategies you can use to calm yourself.
  • Use these to help shift your mood from negative to positive.

How the CSP Framework and other resources can help

The CSP Physiotherapy Framework describes what self-awareness looks like at different levels of practice, and provides resources. Visit the Framework pilot site
Keep up to date
Also, see earlier articles in this series, starting in Frontline’s 5 January 2011 issue.

Robert Millett

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