According to the American Physical Therapy Association, the roles of a Physical Therapist (PT) are to:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
While all Physical Therapists do those things when helping patients, the way that they do it varies with whichever philosophical view they apply to their life. Unless your Physical Therapist is asking you existential questions to ponder while they help heal you, it may be confusing as to how philosophy plays a role in the type of Physical Therapy you receive.
There are three major philosophical views; Dualism, Materialism and Holism. And for those of you that think like my mom when she wants me to binge watch Gilmore Girls with her rather than write a blog, no that does not mean you have multiple personality disorder, are materialistic or are whole. I myself believe that holism is the best, and not just because that’s the best option under my mom’s definitions.
Dualism is the belief that humans have two parts to them, a spiritual or mind aspect and then a physical or body aspect. There are three specific views within dualism which vary in which way the scale tips, towards the mind or towards the body on which is more important.
Substance dualism sees the body as two equal parts so the mind and the body are balanced like on the scale above. Value dualism however states that the mind has more value than the body, tipping the scale towards the mind. Finally, behavioral dualism takes value dualism to the next level and states that the mind controls the body. A physical therapist that has a dualistic view on the world would worry more about making sure that their patient’s mind understands what they will be doing during their sessions and making sure that they are mentally prepared for the sessions. I for one agree that this is necessary but not as much as a value dualist or a behavioral dualist would believe.
In sharp contrast to that, a Physical Therapist that is a materialist would believe that the human body is simply one physical being with no spiritual aspect to it at all. According to Kretchmar (2005), “scientific materialism is grounded in the belief that everything in the world can be explained by principles of math and physics.” Beyond that, there are four specific kinds of materialism. First, there is measurement materialism that is only concerned with analyzing research or observations specifically for collecting data. Next, is monistic materialism which states that the world is one large machine made out of one physical thing. Then, there is reductive materialism where everything is made out of smaller parts that come together to form the larger parts that we see in the world. Lastly, physicalism which takes all of these to the next level in saying that everything we do or experience in this world is meaningless and just one giant accident. From a physicalist’s perspective everything humans do and feel is all genetics and chemicals in our brain which have about as much meaning as dirt.
While math and physics show the research behind why certain treatments work which is especially important when explaining what exercises or treatments will be done during the sessions and why, but not so much when it comes to actually interacting with patients. A major theoretical flaw with all types of materialism is that they lack emotions thus limiting the amount of room for professional success beyond observation and data. While a scientific materialist would be good at helping discover the latest and greatest treatment, the patients that they treated during that experiment most likely did not have a decent experience. Similar would happen to patients of monastic materialism or reductive materialism. A physical therapist with either of those views would only be worried about the physical aspects of healing, not anything to do with how the patient feels or thinks about their recovery. Finally, I think that a physical therapist that is a physicalist would be the absolute worst. Ok maybe not THE absolute worst that spot is saved for Hitler or people that leave puppies on the side of freeways, but somewhere around there. A physical therapist that believes that everything in the world is physical matter with not deeper meaning doesn’t even seem like the type of person that would want to help others get better. However, if they were to become a PT, most definitely would not be a good one as their lack of enthusiasm in the importance of the various exercises and movements needed to help someone return to normal functioning would only hinder the patient’s progress since to them, “goals make no sense except as inconsequential byproducts of our evolution” (Kretchmar 2005). I for one would not go happily through that experience. I would not have scheduled the next appointment and found a new physical therapist.
My personal belief and what I think is the best way to help people is through Holism. Holism sees people as greater than the sum of their parts and believes that their mental being cannot be separated from their physical being and vice versa as they are fused together (Kretchmar 2005). Because of this, a physical therapist with a holistic view will see their patient as a whole person, not just a knee recovering from an ACL tear. This ideal view is rarely used however since most of, “western medicine as we know is now is reductionist in nature” (Maskell). Since these reductive materialists view the world as the sum of its parts medicine is suffering the consequence of being full of specialists that treat only one organ or body system (Maskell). Holists strive to solve the whole problem and help the whole person including their emotions, thoughts and body not just their body. A physical therapist that is a holist will see a patient recovering from tearing their ACL and will heal that while not injuring anything else and making sure that the patient enjoys or at least doesn’t fully despise the experience. In the future, I plan to help the whole person rather than just bring them in for their allotted time, do a series of exercises they need and send them home. That view makes the whole experience seem like a chore. Even though it somewhat is in the sense that it is a hassle and needs to be done to make their life better, but that does not mean that they cannot have fun or at least feel like someone cares while they are there.
Kretchmar, R. Scott, and R. Scott Kretchmar. Practical Philosophy of Sport and Physical Activity. Champaign, IL: Human Kinetics, 2005. Print.
Maskell, James. “What Is Holistic Health & Why It’s Important.”Mindbodygreen. Mbg, 15 Jan. 2013. Web. 17 June 2016. <http://www.mindbodygreen.com/0-7401/what-is-holistic-health-why-its-important.html>.