Being present with the patient—A critical investigation of bodily sensitivity and presence in the field of physiotherapy

ABSTRACT

This article advocates integrating ideas from phenomenological theory regarding the body with a psychoanalytical theory of language to enrich our understanding of the meaning of bodily presence in the practice of physiotherapy. The authors use this theoretical framework to explore bodily presence as a source for physiotherapists’ professional development. They are using research on children as moving and meaning-producing subjects¹

¹ The concept of subject is used in different ways in phenomenology and psychoanalysis, and also in varying ways in each of the two traditions. However, here the concept is used more in line with ordinary language, in the sense that it emphasizes the child’s active position in her/his being in the world.

to illustrate the relevance of their perspectives. They argue that the perspectives might contribute to a physiotherapeutic practice that incorporates bodily presence in the professional language in addition to specific methods and techniques. Understanding bodily presence involves the physiotherapist recognizing the Other (i.e., the patient/child) in the present moment and trusting her/his own capacity to become aware of her/his own bodily presence. The authors assert that being aware of one’s own bodily presence enables therapists to develop an appreciation of their own bodies and the bodies of their patients as they are and move in mutual relation to each other. Applying the article’s theoretical framework, the authors consider the body as the starting point for speech,²

² The concept of speech is used in a wide sense, including voice, tone, and rhythm in line with the article’s psychoanalytical framework of Kristeva and the late Lacan. Thus, the call for being present for the child (as a patient) in the here and now includes participating in the speech of the child, even though the child does not use words.

and suggest that introducing a richer professional language encourages practitioners to become more aware of the dialectic between body and language: how the body is the anchor for speech and how language influences the experience of the body.

KEYWORDS:

• Theory
• body
• presence
• speech
• experience
• children
• physiotherapy

Declaration of interest

The authors report no declarations of interest.

Notes

¹ The concept of subject is used in different ways in phenomenology and psychoanalysis, and also in varying ways in each of the two traditions. However, here the concept is used more in line with ordinary language, in the sense that it emphasizes the child’s active position in her/his being in the world.

² The concept of speech is used in a wide sense, including voice, tone, and rhythm in line with the article’s psychoanalytical framework of Kristeva and the late Lacan. Thus, the call for being present for the child (as a patient) in the here and now includes participating in the speech of the child, even though the child does not use words.

³ One important contribution to articulating the bodily presence between the physiotherapist and the patient appears in the work of Kerstin Ek. Her 1990 doctoral thesis, entitled, Physiotherapy as Communication, includes an empirical and theoretical argument that physiotherapy unfolds as a type of communication. It is not the same as to say that physiotherapy is about communication. That would be to move the focus from what unfolds here and now to an overall level: about communication.

⁴ In making this argument, we echo our “old teachers” including Aadel Bülow-Hansen, Eli Kjerschow Andersen, Lillemor Johnsen, and Liv Skåre, who taught us that “every new patient is a source of insight.” In this sense, we are reiterating an important tenet in the physiotherapy tradition, contextualizing it in a new theoretical framework.

⁵ We are aware that the concepts of subjectivity and intersubjectivity (as we use them) belong to philosophical discussions that we have not addressed. Our point in this article is that being present relies on both.