My Four-Letter Word

It happens every once in a while. Just your ordinary therapy session in progress when one word elicits an over-the-top theatrical wide-eyed gasp, disbelieving, as the hand comes up to the mouth just before the words escape. “WHAT?! What did you just say?! I’m sorry, but we don’t use that kind of language here.”  And what triggers this response? A dirty, filthy, four-letter word. “Can’t.”

That word has no place around me. Say, “You’re crazy,” say, “This is hard,” say, “I’ll try, but I’m not sure what will happen,” but never ever say, “I can’t.”

Therapists do not derive satisfaction from setting people up for failure. I’m the good guy when you have a good outcome. Of course, that’s not to say therapy is always easy or fun. We present ourselves as friendly, laid-back people to establish some trust before we release our inner drill sergeants to push you and our inner cheerleaders to keep you motivated.

Positive relationships and positive outcomes are built on positive communication. Qualifying for therapy tends to be deficit-based. Susie can’t walk. Susie can’t do things that 97% of children her age can do. That may be what the insurance company needs to hear. That information is much less useful to Susie’s family and teachers, who want Susie to be functional and successful. When speaking to the people who are supporting her development, we need to speak in a way supportive of her development. They need to know what she can do. They need to know how they can help. Susie can sit on the floor with her friends during story time. Suzie can stand at an easel and finger paint in her stander. Susie can ride an adapted tricycle around the block. Susie can keep working toward independent transfers and mobility. “Can” creates. “Can” sparks ideas and conversations. “Can” forces us to think about breaking down activities into their do-able components. “Can” helps us structure our thoughts about where we are now and what comes next. “Can’t” is a dead end.

Our language and attitudes are contagious. One of my first grade students likes to wiggle his head into all sorts of strange positions when he gets bored in his stander, which is pretty much anytime he does not have someone’s full undivided attention. I was busy trying to adjust and entertain him when the educational assistant in the class proudly told me that he frequently self-corrects his position when she uses the same type of encouragement she’s heard me give him. “Come on, Jimmy. You can do it! Stand up nice and straight! Use your strong muscles!” Good thing that’s the message I’m sending, because it could just as easily have been, “I just can’t seem to get him to keep his head up.” And if I can’t do it, why would I expect anyone else to do it or think it’s important?

When we write goals, they include, “Joe will….” And why will he? Because it matters to him. Because we believe he can. Because he can.

Do you find that when you focus on the “can do” that it in turn has a positive effect on your clients attitude?