Physiotherapy and Stoicism

Over the past number of years an ancient philosophy has started to flood social media, literature, and modern teachings. Primarily buoyed by the success of recent self-development books by authors such as Ryan Holiday and Alain de Botton on the topic, Stoicism has seen a huge rise in Google searches - and become a common part of the modern-day vernacular. Originally founded by Zeno in Athens, Greece during the 3rd century BC, Stoicism is a school of philosophy that is very much part of the tapestry of these times – and an ethos we can take into our career as learning physiotherapists as we navigate a new year.

Ryan Holiday, someone whose deep, articulate, and well-researched work we recommend at ‘The Learning Physiotherapist’ has spearheaded the re-connection with Stoicism. In his seminal book ‘The Obstacle is The Way’, he highlights how former philosophers, like the great Roman emperor Marcus Aurelius and Seneca, employed the stoic mindset to thrive in civilisations like the Roman Empire. The focus of stoicism draws on their meditations, teachings…how they overcame adversity on their journeys…and remained resilient through hugely trying circumstances - and how they used aspects of pessimism and self-doubt to benefit their value systems.

The fundamental identity of being a stoic, according to what Holiday told the New York Times in 2017, is that while “you don’t control the world around you, you control how you respond”. It is the response that matters, and you can control and own that as a physiotherapist.

The question is how does this ancient philosophy impact and inform quality practice and ethical conduct as a physiotherapist. The influence on people's behaviours to promote positive change is a foundational aspect of physiotherapy, sports physiotherapy, sports medicine, and all other forms of the allied healthcare profession. We must learn as physiotherapists how to become a mentor and guide to our patients, while not over stretching our position as a trusted authority on health and wellbeing. We must facilitate and be collaborative and empowering in our approach, empathetic in our interactions - and considerate with respecting diverse beliefs and values. 

This style of practice is not always easy. It may cause self-doubt as we struggle to grasp the complexity and diversity of each patient we encounter in our physiotherapy practice. It can cause us to question our abilities and skill when confronted with a negative outcome for a patient, or a poor connection and relationship with those who we are ultimately trying to help. However it is a challenge to worth embracing.

Stoicism can show us the means to attempt to hold unbiased and clear-thinking processes. It can solidify our mental fortitude and resilience when we encounter setbacks and obstacles.

Seneca (4 BC-65 AD) Roman philosopher and tutor to the future Emperor, Nero, was an influential statesman during Nero’s reign.

Here are 3 practices we can take from Stoic teachings to benefit our careers as physiotherapists – and thereby promote a stoic mindset as a physiotherapist.

1. Journaling on the obstacles, failings, and success of your practice - We spend huge amounts of time on documenting our treatment plans, interactions, protocols, and outcome measures with clients. However - we often fail to sit and write down how the interactions made us feel. Self-reflective practice is a cornerstone of most academic physiotherapy programmes, but it is often presented as a formal way of understanding one's clinical physiotherapy practice better. The art of journaling in relation to stoicism is about understanding yourself better – as a human being. Start mentoring yourself today by simply spending 5–10 minutes jotting down your thoughts and feelings on today’s events. Remember that there is no perfect way to do this - it is an ongoing learning process; do what works well for you as a learning physiotherapist.
2. Take a view from above - Inspired by Plato, and what is commonly referred to as Plato’s view, this practice focuses on expanding your perception of what is going on to you directly, around you - and in the world right now. Start by picturing from a bird’s eye view the room you are sitting in right now - as you then zoom out from this position start to note all the people in your building or vicinity…then expand to your neighbourhood, your town, your city, your country, and the world. Picture all the people, their troubles, their triumphs, what they are facing, or what they have overcome. See how small you are relative to the grand scheme of things and the entire world around you. This will ground you and give you a perspective as a learning physiotherapist. We are infinitesimally small in the universe - and yet represent everything in our lives. A great stoic philosopher once wrote “the view from above changes our value judgements on things: luxury, power, war…and the worries of everyday life become ridiculous”. Do this 3-minute exercise to recalibrate and refocus your perception of drawbacks in life. Try and remove yourself from your concerns. Remind yourself of your duty to others. Take Plato’s view, as a physio. Start today.
3. Memento Mori - Meditate on your mortality. Perhaps the most misinterpreted aspects of stoicism, this practice is not aimed at causing melancholic feelings about death or our relatively short time on this earth. It is to embrace the vulnerability of life and that it can change at any stage – that each day is a precious gift to us to embrace. Once we harness an appreciation for this gift we can attempt everything we do with a renewed zeal and positive energy - our day-to-day tasks on hospital wards, mundane tasks in clinical physiotherapy practice, taping in the sports physio world, our time with our loved ones…even what can be monotonous daily activities like commuting, administration work or survival tasks like eating and washing. The awareness in knowing and realising we are continuously afforded each day and action we do with nothing else guaranteed, should be both humbling and motivating in giving your all to each and everything you do as a learning physiotherapist. Live each day as if it is your last. 

#learnandgiveback