The Busy PT's Guide to Finding Balance : Education

Bringing Balance to our Emotions

Janey Goude — Tue, 10 Mar 2009 11:42:00 GMT

Years ago, I had a patient whose emotions were out of control. Everything was a huge ordeal. We all know people like this, don't we? They are the ones to whom you'd just like to say, "Get a grip!" For those who tune into reality TV, think Tatiana.

Not all overly emotional reactions are that intense. Most are just mildly annoying. Regardless of their intensity, emotional reactions are not "overly emotional" to the person experiencing them. We give appropriate reactions for our value system. Someone else's response seems too great or too small because they value the situation differently than we do.

During a family vacation, our kids were watching a DVD in the car. Mysteriously, it turned itself off. Three shrieks of horror simultaneously burst forth. The kids had been watching the show for an hour and were engrossed in the tale. My husband and I hadn't been paying the DVD any attention. In fact, we didn't even notice the DVD had cut off; we were completely unaffected. We ascribed no value to the DVD working, but our three girls placed great value on the DVD playing. We had a different reaction to the same stimulus, because we valued the stimulus differently.

But a stimulus exists that would provoke a reaction of similar emotional intensity. There is a situation out there that would produce a shriek of horror from me and my husband...it just isn't the DVD cutting off!

People's reactions are proportionate to the amount of value they place on the situation. Their reactions seem disproportionate to us because we value the situation differently. When we say someone is overly emotional, we are really saying they assign more value to an object or situation than we would.

The take away value here is threefold. A person's "emotional" response is a window into their value system. Instead of focusing on their response, you can acknowledge their feelings, then steer the conversation in a direction that will allow you to learn more about them. "I can tell the DVD cutting off really bothered you. Will you share why that was important to you?"

If you are someone who is referred to as "overly emotional," take a look at how important situations are to you. Do your responses reflect your value system? If they don't, you may want to dial down your responses. But, if your responses do reflect your value system, understand those around you do not place the same importance on situations as you do. You can acknowledge this and request respect for your feelings. "I understand my reaction seems intense. Please give me a few minutes to process this."

Last, realize that our responses aren't consistent. Responses are affected by our world. Our responses are more emotional during times of high stress or pain. Always assume you are seeing someone at their worst and offer a disproportionate amount of grace.

Bringing Balance to our Days

Janey Goude — Tue, 03 Mar 2009 18:25:00 GMT

I love my "to do" list. But I usually have a lot of list left at the end of my day!

My list helps me stay on task. Checking off what I have completed gives me a feeling of accomplishment. And having my appointments, errands, and projects written down gives my mind a much needed rest!

Whether you are a seasoned list-maker or you break out in a cold sweat at the mere mention of the list, one trick to being productive is making the "to do" list work for you. Bring balance to your days with these practical list-making tips.

Divide and Conquer
Break your master list into categories:

What has to be done on a certain day: appointments, assignments with deadlines
What has to be done this week, but not on a particular day: drycleaners
What would be nice to do this week, but doesn't have to be done: scrap booking

Decide what you want to accomplish each day. Write down non-negotiable items first-appointments and assignments. Now you can tell how much time you have left in each day to devote to other errands or projects. Add first from your "need to" list and then from your "like to" list.

Keeping it Real
Most of us are sure we will be able to accomplish more in a day than is humanly possible. So, if you want to make your list realistic, go back and remove half the items you just added!

Dealing with Deadlines
For assignments with deadlines, don't wait until the last day. Start with your deadline date and work backwards. Break up your assignment into mini-tasks, and then give yourself mini-deadlines for each of the tasks. You won't feel so overwhelmed and you will be more likely to complete the assignment on time.

Get 'er Done
Begin your day with tasks that inspire you. If checking off four quick errands motivates you to work on bigger projects, then complete your small tasks first. If you have more energy and concentration in the morning, then you'll want to tackle those big projects as you start your day.

Time to Move on
Have you ever had an item plague your "to do" list for months? When a task has been on your list for weeks-because with the best intentions you keep shuffling it to next week's "to do" list-it's time to realize that particular task isn't important to you. Give yourself permission to remove the item from your list once and forever.

Make sure Life is on your List
For the consummate list-maker, it is easy to get so caught up in checking off our tasks that we forget to spend time living. If you are someone who lives by the list, then make sure you add life to your non-negotiable list. Schedule "life appointments" with your family and friends, even yourself! Make an appointment with life every day. Treat these appointments as you would an appointment with the President. If someone calls and needs that space you simply explain you aren't available as you already have an appointment scheduled in that time slot. You don't have to tell them what the appointment is! I did this just today!

Master or Slave
Make sure your list knows its rightful place. Be willing to toss your list altogether if something truly important comes up. If the thought of living without a list strikes terror in your heart, then you have become a slave to the list. It's no longer your tool, it's your master. For one week, don't make a list. If you miss an appointment, the world won't end. You'll find you will accomplish what is truly important and you'll realize how many unimportant tasks clutter your list and eat up your time.

Share with us what you do to bring balance to your days, even if it has nothing to do with a list!

Bringing Balance to our Communication

Janey Goude — Tue, 24 Feb 2009 16:51:00 GMT

What PT can't relate to being overwhelmed with terminology?! Even if you're not a PT, you'll relate to this post.

In her blog, Lisa Catenacci wrote: I've been reviewing my notes, trying to remember pathologies and how to write my documentation...I was reviewing my notes...when we were learning how to write notes and do SOAP note documentation." (01-06-09)

As a student, I wondered how I would ever be able to keep all of those abbreviations straight. Every clinical seemed to have invented their own nomenclature-a never ending flow of alphabet soup!

Now, without even thinking, I use those once-foreign words and abbreviations in conversation with colleagues, patients, anyone! At some point I realized that if patients were going to understand what I was saying, I'd have to stop speaking in medical terms and return to terms I had been comfortable with BPTS (Before PT School).

Regardless of your career, you encounter field-specific terminology. Do you use that terminology to the detriment of your clientele? Do you forget that they haven't had the education you have? Have you forgotten how confusing your occupational words and abbreviations were B F-I-T-B S (Before fill-in-the-blank School)?

Even for parents! There are times my husband or I will be talking to our kids and they'll stop us with, "Dad/Mom, I don't even know what that word means!" We have the kind of kids that ask, usually. But sometimes they don't. I need to remember my daughter may not yet know what precocious means...even if she is! I want to increase their vocabulary skills, but first I need to lay a foundation of understanding.

Are your clients the type to ask when they don't understand? Do you assume their lack of questions implies understanding? Many people will remain ignorant because they fear their questions will make them look "stupid."

I just finished editing a book on communication. One of the recommendations is good for everyone: If you want someone to understand you, use short sentences. Preferably, short sentences with little words. And a little repetition never hurts either!

Think: Run, Spot, Run! That sentence may not make for enthralling reading, but Spot knows what you expect from him! Too often our children and clients hear, "Scuttle, Soupçon, Scuttle," when they need to hear, "Run, Spot, Run!"

Ho Ho Ho…Who are you Listening to?

Janey Goude — Tue, 09 Dec 2008 16:24:00 GMT

Financial gurus analyzed shopping trends following Black Friday. Shopping was up almost 4 percent from last year this same time. While "four" is a low number, I thought "up" was good. I was wrong.

Yes, it was an increase; but they warned, in these difficult economic times, we should not take the increase as a good sign. Retailers should not be pleased with their increased sales; this increase was actually an indicator of gloomy days ahead. You see, the only reason more dollars were spent on this Black Friday is because people completed the majority of their shopping on that day. According to the experts, now that the biggest sale day of the year was past, people were mostly through Christmas shopping.

This was great news for me. I'm not sure which I dislike more, shopping or crowds. So, with the rest of the US finished Christmas shopping, I went to the mall today to get some of my shopping done. The third Saturday before Christmas and I'm at the mall. Insane. But, if most everyone is done shopping, then no crowds! Right? Wrong! The mall was packed. Absolutely packed.

The shopping areas by the mall? Packed.

Toys R Us? Packed!

So, either people love to look for what they can't buy, or the few people who still have money to spend ALL came to South Carolina TODAY! Or maybe, just maybe, the gurus were wrong.

The most valuable information I gained from my research class was not how to conduct research or how to write-up research. I learned how easily statistics can be manipulated. You can make the same number say a lot of different things. And if you speak well enough, loud enough, and long enough...enough people will believe you to effect a change, even if the change is based on a lie.

Situations are rarely as they seem. People are quite often not as genuine as they come across. And when someone is trying to convince you to do something, it is usually for their own benefit. But sometimes even the good guy, with the best intentions, gets it wrong. We humans are an unpredictable lot, and that makes for a challenging variable.

Today, I was reminded that those who are lauded as "experts" don't always have all the answers. Part of finding balance is using wisdom when we apply information. As we navigate the coming days, let's be careful whose voices we listen to.

Perfection

Janey Goude — Tue, 07 Oct 2008 15:21:00 GMT

I have a friend who is a single mom of three children. She was working a job at night while going to school during the day. In an email detailing her final days of class, she commented that she'd finished her final paper and it was good enough to warrant a B. Her next comment is what this blog is all about: finding balance.

"I could get an A, but I've spent all the time I'm willing to spend on this paper. I'm not willing to take away any more time from my kids. A ‘B' will have to be good enough."

Quite honestly, before I received that email it would have never occurred to me to turn in a paper before it was perfect. That email was the catalyst for a lot of soul searching.

I've always known I was a perfectionist and viewed that as a positive-I excelled at tasks I set out to do. But since that email, I've seen myself in a different light. Turns out that, for me, perfection translates into an "all or nothing" personality, which is a problem when it comes to finding balance.

At home, I see it in something as simple as watching a movie. I could leave the TV off all day and not think twice about it. Actually I prefer to keep the TV off. BUT, if I begin to watch a movie, even if it is one I have already seen, I have a very difficult time turning the program off. "All or nothing." Once I start a task, I complete it at all costs. There is no balance there.

As a clinician my "all or nothing" personality translated into mixed comments on my performance reviews. Praise for outstanding, detailed note writing-I never had a claim denied. Criticism for the time I spent on paperwork. Well, duh. If you want it done right...I excused the time it took as necessary to achieve the desired outcome.

Ah, there it is. There's the kicker. Whose desired outcome? In my home with family, at work with clients, co-workers, and supervisors...whose outcome am I achieving? Do I drive myself nuts cleaning my home because I want it for my family, or because I want it for myself? Did my supervisor require notes detailed to the degree I wrote them? Or was that my personal goal?

When I seriously look at my life, I have to admit that perfection is all about me. Rarely are my goals designed to meet someone else's expectations. I'm meeting my own need for "all or nothing"-and in doing so I'm falling painfully short of my most important goal: finding balance.

To all the perfectionists out there, I issue this challenge:

List the goals you think you are achieving for someone else.

Take that list and go to those people whose goals you think you are meeting.

Ask them what their goals really are.

Betcha they aren't what you wrote down!

For those who work with or love a perfectionist, know that they honestly believe they are doing what they do for you. Gently encourage them to enjoy life in all its imperfections.

He's Eating His Eye!

Janey Goude — Tue, 10 Jun 2008 13:41:00 GMT

My first student clinical rotation--observation in the University Children's Hospital-- provided one of my most memorable client interactions. My CI had to speak privately with the mother and requested I keep an eye on the client, an 18 month old modern day Helen Keller. I can honestly say I never, not for one second, ever considered his own face a possible danger. Goes to show how much I had to learn.

I watched with amazement as this little guy navigated the room on his head, two knees and one hand--using his other hand as his eyes, to "see" where he was going and feel for obstacles. He maneuvered to some toys in the room and sat upright to play. Suddenly he reached his hand to his eye, plucked it out, and placed it in his mouth. His eye...in his mouth!

I was stunned speechless for a moment, then tentatively uttered, "He, he, he...he's eating his eye. He just put his eye in his mouth." Without turning around the therapist calmly explained, "Oh, he does that sometimes."

Excuse me? He does that sometimes? REALLY? Yet, you didn't feel that was a useful piece of information to provide a student on her first encounter with this client? In retrospect, I suppose I should have clued in that it couldn't have possibly been his real eye. I mean, no blood, no screaming and writhing about. My twelve year old could probably have figured that out...but way back then we didn't have "Life in the ER"!

So here's the question...do you give your students and co-workers enough information? Or do you take for granted the knowledge you have? As you are training students and new employees, try to remember what it was like to be new. Don't assume they have more information than they actually do. Better to hear information twice than not at all.

Canines, Kids and Clients (Part 1)

Janey Goude — Tue, 20 May 2008 15:01:00 GMT

Puppies learn social behavior boundaries when they are 3-7 weeks old, playing and interacting with littermates--behaviors like bite inhibition: how hard I can bite before my littermate squeals in pain and won't play with me anymore. Gradually the puppy learns to adjust the strength of his bite from just playing to an all out attack. According to Dr. Dodman, "Playing helps puppies learn what does and doesn't offend others, how to say ‘I'm sorry,' and how to assert themselves to get what they want." If a puppy is removed from littermates during this time, not all social behavior will be learned. An interrupted learning period can result in an adult dog with behavior problems. Like canines, kids and clients can also be adversely affected when their natural learning is disturbed.

Like canines, human parents instinctively protect our young. We childproof our home, use parental controls on TVs and computers, and closely monitor our children on the playground. But sometimes we come to little Johnny's rescue too quickly. When we jump in to save our children from harmful consequences--physical or social, we are depriving them of the opportunity to learn valuable skills on their own. Just like that puppy who learns bite inhibition from his siblings, children learn valuable social boundaries from their peers: how to "play nice" with others.

This is one of my biggest parenting challenges--walking the fine line between when to let my children learn from the school of hard knocks and when to intervene. When I see a child mistreat one of my kids, my first instinct is to run in and save the day. As they grow older, I'm learning to hold back and let them fight their own battles.

We got a small 4-½ pound Maltese for Christmas two years ago. Bo is highly tolerant of my children's handlings...when he is not quick enough to scamper out of their reach. He will give warning growls, but he never bites hard enough to deter them. Despite our best efforts to teach my son, Jake, how to be gentle with Bo, he still persists in pestering him. Last summer Jake encountered Coco, my sister's 70 pound Rotweiller mix. She was not so tolerant of being boy handled. One snap from her strong jowls sent Jake scampering. He gave Coco a wide birth the rest of our visit. Coco accomplished in one snap what I failed to teach in two years of lectures. Experience is by far the better teacher.

Certainly there are some lessons too dangerous for children to learn the hard way. On the other hand, sometimes the greatest long term protection we can give a child is a little short term pain. Children learn responsibility from enduring the unlovely consequences that result from their actions. When we rescue our kids from all of life's harsh realities, we set them up for failure.

Next week, we'll look at how that is also true for our clients.

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Information in first paragraph taken from "Best Behavior-Unleashing Your Dog's Instinct to Obey" from "The Good Dog Library" from Tufts University. Scientific Editor: Dr. Nicholas H. Dodman

Higher Education: At What Cost--For What Gain?

Janey Goude — Tue, 01 Apr 2008 11:19:00 GMT

This weekend, I passed a couple talking on the street outside Starbucks. A young man sweeping the street engaged them in conversation:

Sweeper: Do you like music?

Man at table: Yes.

S: What kind?

MaT: All kinds, but especially classical.

S: Really?

MaT: Yes. I study classical music.

S: Oh, are you getting your Bachelor's or Master's?

MaT: Doctorate.

S: Oh. (his voice dripping with admiration)

By this time I'm exiting earshot. My first thought, was, "Wow. Impressive." Followed quickly by, "What do you do with a PhD in classical music?" The reality of his options made the pursuit not so impressive.

I know people who make an occupation of education to avoid having an occupation. I think they are affectionately referred to as "career students". Education is a noble pursuit, but it is not an end unto itself. There has to be a reason for the education.

When I was in PT school, the Master's program was just gaining popularity. The college I attended entertained the idea of transitioning to a Master's program. The PT faculty convened a student board to gather feedback and gave them the proposed curriculum to review. There were many intellectuals in our group who were enthralled with the idea of going to a Master's. But as we deliberated, we found that essentially no material was added to the Master's curriculum. They had merely stretched our four year program over five years, collecting another year of tuition.

Our conclusion was that if anyone deserved a Master's degree it was us--completing the same amount of information in one year less. It was our contention that it took less intelligence and character to complete their proposed Master's degree than to complete the current Bachelor's degree. They would be turning out weaker students, but awarding them with a higher degree. What good would that do our profession?

We must have made a good argument because the Master's degree was tabled. Eventually my alma mater did go to a Master's, but I'd like to think it was a revamped, higher octane version.

There are people who are impressed with degrees. There always will be. But what do those additional credentials mean? Do they mean anything? Or are they just more money for the colleges? What does that additional education allow you to do that you can't do with a lesser degree? If the degree opens doors that would otherwise remain closed, then it is a worthy pursuit. If the degree merely allows you to put off entering the real world or put money in the college's pocket, then it is an end unto itself and of no value to society or to our profession.