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Rainbows & Roadblocks

Three years ago I was sitting back in a workshop on psychological interventions into pain, the speaker asked us to turn to the person beside us and speak for one minute about the positive attributes of one of our patients. The catch was, it had to be the client that when you see their name in your appointment book, you just sigh and feel drained before you have even seen them. My partner went first and talked about her person for the minute and spoke beautifully.   When it was my turn, I went to open my mouth to talk about a lady I had seen in the clinic to say something positive, and nothing came out. I sat there in silence for the whole minute, I was horrified with myself that I couldn’t find the words to say anything positive.  My judgements and internal models of this lady meant i was not seeing her as a rainbow ( a beautiful and unique gift of nature) but as a roadblock (Harris 2019) . This was a good lesson for me to not just focus on the negative with patients but try and see the light. Now when I get stuck with a patient, I ask myself the question Do I see this person as a rainbow or a roadblock?


After a new person has come in to see me in the clinic, I like to work through an ACT case formulation worksheet to allow me to better identify the different processes that may be maintaining this person’s predicament, in the context of their world. One of the questions near the end that I love and hate is- MY PERSONAL BARRIERS? (What difficult thoughts and feeling show up for me, regarding this client?). I also ask myself further questions:

What biases do I hold?

How am I perceiving this patient?

Can I hold a safe space for this person?

Do I have a preconceived internal model of this patient?

Is it me who is the roadblock? and stopping this patient from moving forward?

Over the years practitioners have written in their notes “patient was not compliant with their exercises” or similar, shifting the blame onto the patient for not getting better. When this happens, we need to sit back and reflect, how can I better cultivate an environment of openness, non-judgemental (or at least minimal judgement), to give this person the space to explore their experience? Reflective practice with yourself is a really challenging and important aspect of care, to make sure I am giving the person the best environment to flourish and grow. When you become stuck with a person ask yourself the question  do I see this person as a rainbow or a roadblock? A rainbow is a unique and beautiful work of nature. Can we truly appreciate the gift granted of working at a deep level with our fellow human beings (Harris, 2019)


Harris, Act made simple, New Harbinger publications, 2019