Curiosity & Play
Last year I did an interview with a person that was suffering with debilitating pain, during the interview she reflected that I was curious to know more about her whole experience. I created a space where I was open to her whole experience and areas of her life that she has not explained to other MSK clinicians. She was intrigued to know why I wanting to know more, how does this fit with her pain? After exploring her experience for 90 minutes, we then started to help her make sense of how all of this fit together. We did this through careful exploration of her emotions, beliefs, environment, and her bodily responses and how these may interact together. She was starting to reconceptualise that what she was going through was much more than damage equalling pain.
The mission we set for her was to explore her back pain but in a curious way, where is it, how does it feel, what thoughts are happening and what would happen if she relaxed the body and stopped fighting it. The processes at play are present moment awareness, self as context, defusion and a willingness to be with pain. We were playing with context, helping to cultivate a shift in her relationship to her pain. The next week she came in happy and excited, she had taken photos of herself bending with bracing and protection, then photos of her moving in a relaxed mode, the change was seismic. We can hypothesize that there was a large expectation violation triggering a lot of prediction error, which triggered updating of her models of the world. The range she was moving through was life changing for her, the reconceptualization that she could move again and do what she valued most.
What we were seeing here was a person starting to make sense of her experience through play and experiential learning in the context of her world. “Facilitating a space to create an optimum environment to explore” (Rathbone, 2022). What we commonly see with people in pain, is they loose flexibility in life, move less, engage in activities less, withdraw from social events, trying to control their environment to protect themselves and decrease error in their system. This is probably a good strategy in the short term, but not so good in the long term. Having an environment to encourage people to explore their world again to cultivate more curiosity and flexibility is really important.
“When we’re fully present with our clients, open to whatever emotional content arises, defused from our own judgments, and acting in line with our core therapeutic values connection, compassion, caring and helping, then we naturally facilitate a warm, kind, open, authentic relationship” (Harris, 2019)
Creating this space to explore and play will hopefully flow through their life, giving them permission to explore their world again.
“An agent that is able to remain at the edge of order and disorder will combine flexibility with robustness” (Miller, Reitveld, Kiverstein 2021)
“Frequenting this edge of criticality requires that predictive organisms are prepared to disrupt their own fixed point attractors (habitual policies and homeostatic setpoints) in order to explore just-uncertain-enough environments that are ripe for learning about their engagements” (Miller, Reitveld, Kiverstein 2021)
Just the right amount of curiosity about our world will allow us to gather information on affordances in our environment, giving us more ways to respond to our ever-changing world.
In the clinic let’s give people a space that invites them to explore their experience and what it means in the context of their world and how they interact with their world. Slowly cultivating a curiosity to explore and along the way fostering more flexibility, so they can adapt to whatever the world throws at them and engaging again in what makes them, them.
References
Miller, Reitveld, Kiverstein, The predictive dynamics of happiness and wellbeing, Emotional review, 2021
Rathbone, Beams, Le Pub scientific, Making sense, 2022