Paradoxical Failures, Pt. 2

by twofiftyorless

(Cont)…Mr. Gladwell suggests that the only way to prevent an athlete from choking is to change the environment. In the instance of Jana Novotna:

The only thing that could have saved her is if–at that critical moment in the third set–the television cameras had been turned off, the Duke and Duchess had gone home, and the spectators had been told to wait outside. In sports, of course, you can’t do that…Choking requires us to concern ourselves less with the performer and more with the situation in which the performance occurs.

Choking, like pain, is contextual (read: Neuromatrix). Unfortunately for the athlete, their environment is non-malleable; the crowd will not go home and the cameras will not turn off. Likewise, the patient in pain does not get to choose the culture they are a part of.

Fortunately for the patient in pain, however, they have greater control over the context of their pain experience. The athlete has to play their game or match at a predetermined time, at a predetermined location, against a predetermined opponent. Their choices are limited. The patient, on the other hand, can choose what they do, when they do it, and who they trust to do it with. This is where the skill of the clinician is important. After all, “If the motion necessary for relief must come from the patient, it is only likely to arise within an environment full of acceptance and faith in their inherent abilities.” (2)

How do you set up your therapeutic environment to assure that the negative influence of the culture is suppressed?

How do you help your patients learn to stop choking?


(2) The Analgesia of Movement: Ideomotor Activity and Manual Care