Barrett L. Dorko, P.T.
"When you look for the bad in mankind, expecting to find it, you surely will." Abraham Lincoln
The onset of pain represents a shift in the often delicate balance between the deforming of our tissues and our tolerance for that. Although inflammatory processes can certainly decrease our tolerance, I think that resolving that is fairly easy compared to what we're asked to do manually for the deformation.
When someone comes to me in pain, I assume that my job is to both enhance their tolerance and decrease the adverse mechanics in their body. I know that the former has been overwhelmed by the latter, so why people hurt is certainly no mystery.
I find most clinicians agree with my reasoning up to this point, but that this is where we begin to diverge. My assessment and strategies of care are markedly different because I employ what I've come to call "The Pollyanna Doctrine."
Let me explain.
Many baby boomers, such as myself, were approximately the age of Haley Mills when she starred in the Disney classic "Pollyanna" in 1965.
This was the first of several enormously popular films that led to her capturing the hearts of countless boys and the admiration of the girls. Even today, my daughter Jennie loves this story, and the young actress.
Anyway, "Pollyanna" follows the exploits of a young girl newly arrived in a small town, about the turn of the century. She holds the view that within every situation and each person is something good, and that this can be noted and amplified in such a manner as to make our existence easier, to make us glad that we are here.
I notice, these days, that referring to someone as a Pollyanna implies that they don't see the negative aspects of a situation, or that they are generally in denial. But I see no indication in the movie that she ignores such things. On the contrary, she often points out the deficiencies in others.
The Pollyanna Doctrine
Within every patient is an attitude, process or movement that, when amplified, will assist in recovery. Assessment and treatment should include acknowledging these, and making the patient aware of them.
The technique and methods I personally employ depend upon self-correction, self-awareness and a deepening of the diaphragmatic breath, so this doctrine is essential for success.
When I think of the ways that therapists ordinarily describe their patients, and consider what most evaluation forms emphasize, it's clear that Pollyanna's attitude is rare in our profession, and it is no wonder that my methods of handling are not often employed by others. I work to raise the patient's tolerance for deformation while simultaneously reducing the mechanical origin of their pain. This can be remarkably effective, but it requires the patient's motivation and trust to accomplish. I never got this from patients when I was acting like my favorite character in the movie; Reverend Ford.
Played by Karl Malden, the reverend is a judgmental, shaming individual, loudly promising damnation for anyone not heeding his tirades each Sunday.
One day Pollyanna finds him practicing another venomous sermon. She asks him if he likes being a minister.
The reverend is amazed by such a question, but she explains that her late father was also a preacher, and that he became saddened by his inability to get his message across. She says, "But then one day he read something that helped him. I have it here in this locket. It's the only thing I have of my father's."
Reverend Ford reads the quote at the beginning of this column and is transformed.
The movie ends with Pollyanna leaving for the hospital after a fall and subsequent paralysis. Her presence in this formerly austere, and undemonstrative town has changed the inhabitants so much, that they gather as one to wish her well.
Reverend Ford, the most profoundly changed of all, utters the final line as she is carried past him. The words have never left me, and I carry them with me to the office each day;
"We looked for the good in them, and we found it."