“How does that feel?”

Can you hear yourself asking that of a patient?

I know I have heard myself say it as a patient performed an exercise task.

On the surface it seems like a straightforward question, but for the patient, it can be unsettlingly vague. They often have no idea what kind of answer is expected, or even what the question means, and so, feeling vulnerable, they offer…

“ Um – OK.”
or
“I don’t know.”
or
“I can still feel some pain..” because in past conventional clinical encounters, that is what the clinician has wanted to know with this question.

Interestingly, we often don’t have a clear idea of what information we are asking for either.

It might be that we want to know if their presenting symptoms are still present. Maybe we want to know if anything is different. Perhaps we want an insight into how the person is using themselves. It could be that we want to know if the objective for the task is being met, so that we can adapt it or choose another option.

“How does that feel?” can so often be a dead end, rather flabby question that doesn’t yield good quality information to inform your next clinical decision. Nor does it necessarily help a struggling patient to experience an insight or moment of awareness on their own.

If the question changed to “What do you notice?”, the patient’s attention changes. The emphasis shifts from worrying about whether they are feeling the “right” thing, to giving you valuable information.

It also opens the opportunity to further focus the question if necessary, with “What do you notice when..” or “What do you notice about..” or “What do you notice when you compare it to..”.

Now the patient has something much more specific to work with. You have focused their attention and removed a layer of disconcerting uncertainty. After all, they cannot get the answer wrong – you are asking them to report on their own sensory experience.

They are no longer just receivers trying to get it right, but collaborators on a voyage of discovery.

• Caveat: “How does that feel?” may be used to harvest a broader sense of the patient’s way of perceiving and processing their experience, and can lead to some interesting responses, often to do with their emotional, rather than sensory response. (“It makes me feel light” or “happy” or “worried”). Some patients blossom with that degree of open questioning, but I tend to find that this ability develops over a number of sessions, as they learn to trust in the process and trust you to value and respect their feedback.

There is so much more to clinical practice than what we do – the magic and power is more often in how we do it. This is where the science and art of clinical practice intersect. Instead of chasing a proliferation of new techniques,  we calmly learn to make the most of what we do with greater discernment – and start moving towards mastery.

If you love this aspect of clinical practice and would like to develop in it further, I warmly welcome you to join us on our next JEMS Movement ART online programme.

https://www.tickettailor.com/events/jemsmovement/796761/r/li230113/

If you have any questions or want to find out more, please email Coral at info@jemsmovement.com