THE CHELSEA EXPERIENCE: THE WHOLE-PERSON COACHING APPROACH

Richmond Stace MCSP MSc (Pain) BSc (Hons)

How we met

pain & dystonia met

shared characteristics Complex biology ‘in the dark’ Emerging in the person Embodied Lived experience – ‘moment to

moment’ Influences

Emotional state Attention Expectation

complex biology All biology pertaining to sensing and

moving… Experience now: prediction of what ‘this’ all

means And then influences upon sensing and

moving: e.g./ Thoughts Emotions Environment Prior experience

Biology in the dark Inside the skull, the body Somehow creates our reality pain,

dystonia, vision Action shapes this biology that shapes

our on-going experiences and reality Bi-directional This creates opportunities for change…in

a new direction

dystonia The person experiences & suffers

unwanted movements and the effects thereof

Movement Planned then executed What is the job in hand? Usually precise ‘Over-steer’

the story What is the trigger?

Stress, emotion, a context?

That point is not in isolation

Often a backstory stiffness, tightness, gesturing, posturing

listening to the narrative The story unfolds allowing for a meaning Opportunity to explain what has

happened and is happening They describe their lived experience Our aim (together – cooperation) is to

change the lived experience in a meaningful direction

Where the ‘treatment’ begins

lived experience Altered movement – observe and test Altered body sense – tactile discrimination World (environment) perceived differently Facing the world Altered sense of self How does the world see me? Impact factor – limitations, avoidance? Self-confidence, self-efficacy

coaching Person becomes their own coach Moment to moment thinking and action Thinking and action aligned with vision of

healthy self Promote independence, belief in self Growth mindset Practice & quality – take every

opportunity Motivation, effort, resilience

the context and the mindset Set it up Understanding Environment,

thought patterns, what is happening now?

Practical mindfulness Like ploughing a field

before sowing the seeds

sensorimotor training: touch Expected in

physiotherapy Develop

relationship Warm touch

(have warm hands!)

Social touch for co-operation

Sensorimotor: stroke (caress) Signals to

sensorimotor areas

Rapid stroke/caress

Like stroking a dog Sculpting body

sense Use it or lose it

Imagery Recognise training: left/right judgements Watching others move ** Imagined movements

Planning stages of movement ? affecting prediction of next movement Often see small movements starting –

overspill Often improved quality movement & body

sense

Visualisation Creates calm with mindfulness Evoke certain feelings and sensations Visualise normal movement – often hard Cultivate ‘confident you’, belief in yourself Helping with the prediction Maintains alignment with healthy vision

and associated good feelings Motivation & resilience

Tactile discrimination training Develop body sense Body sense key for normal movement Sensorimotor Thick and thin: aka cork and pen Concurrent with stroke + look;

movement training

Actual movement Best quality Aiming for precision (relies on improving

body sense) Repetitions (practice +++) Feedback -- mirror Integral with sense of body &

environment Context affects movement – where to

practice?

Self-awareness Awareness towards dystonia anxiety,

more unhelpful thinking, more unwanted movement etc.

Focused attention training aka mindfulness Letting go of unhelpful thoughts Focus on healthy action

Summary: whole person Focus on the lived experience:

Who they are How they move How they feel What they feel How they envision themselves

Interaction between all – their reality

contact Richmond Stace Web & blog:

www.specialistpainphysio.com painphysiolondon@gmail.com Twitter @painphysio T. 07932 689081