“Help me.”

Have you ever thought about how much courage it takes for a person in chronic pain to say that?

They asked for help back when their pain was a minor annoyance. They asked again when their pain began to change how they lived: when they realized what they were giving up just to get through the day.

They’ve asked for help, over and over again—and they have no reason to believe that, this time, they will find the answer. They are dis-couraged.

And now, here they are in your office, doctor (or massage therapist, or PT, or personal trainer, or yoga teacher, or Pilates instructor…)—and they want to know what to do.

The answer is rote, practically automated. “Do these exercises, in this order, until I tell you to stop.” Take two Pilates classes and call me next week.

Prescribing exercise as a form of treatment is a gamble; it means that your clients’ improvement will be dependent upon their ability to perform the work they’ve been given. But for a client living with chronic pain—chronic discouragement, in essence—that’s not a bet I’m excited about taking.

I don’t just want to get them out the door; I want them to get better. And giving them a list of exercises that they may or may not do correctly, if at all? That’s a copout. And it’s predicated on the mother of all copouts in our industry: the idea that our clients’ willpower is entirely out of our control.

What makes us so sure?

What if it’s not on them? What if our interventions, however cleverly devised or well-intentioned, are still out of our clients’ emotional reach?

So much of our energy goes into making clients better, as it should. But we do more good when we devote some energy into making better clients.

How do you inspire your clients to care? It can’t just be a reduction in pain; “not pain” isn’t something to aspire to. “No pain” is the minimum.

You will not fix a body that its owner fears. You need to lend them courage.

Get them to walk through the door and to be fully there, in the room. Then—the hardest part—you have to make them smile. And not at you: inwardly. You have to show them that the pain is a small, insignificant piece of a larger, astounding machine. You have to tell them how it works so that they dazzle at the truth of it.

Teach your clients to want their body: every piece of it, pain and all. Focus their attention so intently on love for their own bones, their own skin—every muscle, every cell—that moving becomes fun.

There’s a trick to doing this, and that trick is to like them, and let them know that you like them. Acknowledge their courage. Respect their sacrifice. They haven’t failed: they have survived. Like your clients when they are in pain, just as much as you like them when they are not—and they will learn to do the same.

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