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THE CHELSEA EXPERIENCE:
THE WHOLE-PERSON COACHING
APPROACH
Richmond Stace MCSP MSc (Pain) BSc
(Hons)

shared characteristics
? Complex biology ��in the dark��
? Emerging in the person
? Embodied
? Lived experience �C ��moment to moment��
? Influences
? Emotional state
? Attention
? Expectation

complex biology
? All biology pertaining to sensing and moving��
? Experience now: prediction of what ��this�� all
means
? And then influences upon sensing and
moving: e.g./
? Thoughts
? Emotions
? Environment
? Prior experience

Biology in the dark
? Inside the skull, the body
? Somehow creates our reality ? pain, dystonia,
vision
? Action shapes this biology that shapes our on-
going experiences and reality
? Bi-directional
? This creates opportunities for change��in a
new direction

dystonia
? The person experiences & suffers unwanted
movements and the effects thereof
? Movement
? Planned then executed
? What is the job in hand?
? Usually precise
? ��Over-steer��

the story
? What is the trigger?
Stress, emotion, a
context?
? That point is not in
isolation
? Often a backstory ?
stiffness, tightness,
gesturing, posturing

listening to the narrative
? The story unfolds allowing for a meaning
? Opportunity to explain what has happened and
is happening
? They describe their lived experience
? Our aim (together �C cooperation) is to change
the lived experience in a meaningful direction
? Where the ��treatment�� begins

lived experience
? Altered movement �C observe and test
? Altered body sense �C tactile discrimination
? World (environment) perceived differently
? Facing the world
? Altered sense of self
? How does the world see me?
? Impact factor �C limitations, avoidance?
? Self-confidence, self-efficacy

coaching
? Person becomes their own coach
? Moment to moment thinking and action
? Thinking and action aligned with vision of
healthy self
? Promote independence, belief in self
? Growth mindset
? Practice & quality �C take every opportunity
? Motivation, effort, resilience

the context and the mindset
? Set it up
? Understanding
? Environment,
thought patterns,
what is happening
now?
? Practical
mindfulness
? Like ploughing a
field before sowing
the seeds

sensorimotor training: touch
? Expected in
physiotherapy
? Develop relationship
? Warm touch (have
warm hands!)
? Social touch for co-
operation

Sensorimotor: stroke (caress)
? Signals to
sensorimotor areas
? Rapid stroke/caress
? Like stroking a dog
? Sculpting body
sense
? Use it or lose it

Imagery
? Recognise training: left/right judgements
? Watching others move
? ** Imagined movements
? Planning stages of movement
? ? affecting prediction of next movement
? Often see small movements starting �C overspill
? Often improved quality movement & body sense

Visualisation
? Creates calm with mindfulness
? Evoke certain feelings and sensations
? Visualise normal movement �C often hard
? Cultivate ��confident you��, belief in yourself
? Helping with the prediction
? Maintains alignment with healthy vision and
associated good feelings
? Motivation & resilience

Tactile discrimination training
? Develop body sense
? Body sense key for normal movement
? Sensorimotor
? Thick and thin: aka cork and pen
? Concurrent with stroke + look; movement
training

Actual movement
? Best quality
? Aiming for precision (relies on improving body
sense)
? Repetitions (practice +++)
? Feedback -- mirror
? Integral with sense of body & environment
? Context affects movement �C where to
practice?

Self-awareness
? Awareness towards dystonia ? anxiety, more
unhelpful thinking, more unwanted movement
etc.
? Focused attention training aka mindfulness
? Letting go of unhelpful thoughts
? Focus on healthy action

Summary: whole person
? Focus on the lived experience:
? Who they are
? How they move
? How they feel
? What they feel
? How they envision themselves
? Interaction between all �C their reality

contact
? Richmond Stace
? Web & blog: www.specialistpainphysio.com
? painphysiolondon@gmail.com
? Twitter @painphysio
? T. 07932 689081

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Physiotherapy Dystonia Network Meeting 11th March 2016

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Physiotherapy Dystonia Network Meeting 11th March 2016