Recovery Support Specialist Case Study Preya Porter 5-18-15

As a licensed physical therapist, the most common ailment I see in my daily practice is chronic pain. Through out the years I have tried various physical approaches to help my patients including ultrasound, electrical stimulation, ice and hot packs, exercise, joint mobilization and deep tissue massage. Regardless of all my well intentioned efforts, their pain level would only diminish slightly. Frustrated, I continued to search for anything within my scope of practice that would help alleviate their pain.
In my search, I discovered the Upledger Institute and their osteopathic approach to treatment. In the osteopathic approach, the focus is to reduce tissue tension to facilitate the innate healing processes of the body. I also learned that there is an emotional component to patient physical dysfunction. This had confirmed something I had already known intuitively, that when patients were under increased stress their pain symptoms were generally worse. I was thankful that I now had a way to treat physical pain by accessing emotional memories in the tissues to aid in their healing. With this new tool in my tool box, I was excited to see my patients’ pain issues improve. My patients were getting better, however, there was still something missing.
During this time, I was going through my own personal crisis and was spiritually seeking. This is when I came to know my Savior Jesus Christ. By His Grace, I was able to discover the missing piece, that we humans also have a spiritual body. Because we are a 3 part being with spiritual, emotional and physical bodies which are deeply intertwined, it is impossible to treat physical pain without addressing the emotional and spiritual issues too. This understanding and the desire to help patients deal with their pain has been my motivation for pursuing my RSS in order to obtain the tools necessary to assist them with their spiritual issues.

Case Study

Patient BW, a 49 y.o. white female presents with jaw pain, neck pain, and bilateral hand paresthesia. Patient reports she has sustained multiple traumas from working cattle. Patient currently works full time in an office, is married and has one child. Patient was treated with extensive osteopathic manual therapy to release multiple soft tissue restrictions. Pain symptoms would relocate to different areas of her body, but with little decrease in intensity indicating a substantial emotional component to her pain.

In order to approach the emotional aspect of pain with BW, the patient was educated in how increased stress causes increased emotional turmoil which leads to increased pain. With improved rapport, BW began to describe her stresses including her job, husband and child and how she was managing them. The patient’s primary coping mechanisms were denial, “stuffing” or drinking alcohol. I discussed with patient the importance of learning how to manage stress in a healthy and functional way and how this was vital to her physical health. BW was advised to begin journaling as a way to externalize her issues instead of internalizing or “stuffing” them, to avoid their manifestation as physical symptoms. BW was agreeable to this. The patient began to report decreased anxiety and some decreased pain, however small increases in her stress level would continue to cause 10/10 pain and her body would completely decompensate.

As our patient/therapist relationship continued to grow, BW was educated about her spiritual body and how it affects her physical and emotional bodies. She was also educated in her true identity in God and that a relationship with her Heavenly Father was the only way to gain spiritual peace and thus physical and emotional peace. We discussed the use of the 12 steps from AA as a practical way to apply the gospel to everyday life. BW was familiar in the 12 steps due to her first marriage to an alcoholic when she frequently attended AL anon meetings. The patient was educated on the true Christian roots of the 12 steps and was agreeable to applying them in her daily life.

Throughout our treatment sessions, BW has discovered many truths about herself, including her past resentments towards her mother, ex-husband, concerns about her job, child, current husband and her expectations of herself. She continues with some pain, however increased stresses in her life no longer completely decompensated her physical body. BW demonstrates increased peace and joy and has learned how to maintain healthier emotional boundaries. BW does journal, pray and go to church regularly and has learned that her Higher Power is truly in control.