Josée Lachance, Ph D (c)1, Pierre Paillé1, Jean-François Desbiens1 et Marianne Xhignesse2 - Josée Lachance Ph.D
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Josée Lachance, Ph D (c)1, Pierre Paillé1, Jean-François Desbiens1 et Marianne Xhignesse2 1Faculty of Education and 2Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada IHSRC 2016 (Ottawa, Canada) July 5nd 2016 1
Background Developed in Europe in the 1980s Awakening the “Sensible” Being (ASB) is a formative practice geared toward care giving and support. Examines how experience of the body and its movement allows for the development of presence to oneself and to others, both of which are desirable qualities for health-care professionals. Four intervention methods enable learning: manual therapy sensory gymnastics sensory introspection verbal interviews focused on body experience 2
Background (cont’d) According to Large (2009): A particular quality of presence is developed in ASB participants. They: are closer to their inner world; are more able to verbalize their feelings to others; set actions into motion that express what they are in the process of becoming. Participants experience many gains: Ex.: « increased adaptability, autonomy, stability; deeper sense of self-esteem; increased assertiveness while being closer to others » (p. 407). 3
Background (cont’d) Other literature findings: Changes in the representation of ideas, values, self- image and perceptual relationships (Bois 2007) Changes in participants’ conception of health (Duval, 2010; Cencig and Humpich, 2009) To our knowledge, there have been no studies to explore the effect that ASB training might have on physicians. 4
Purpose of Study the quality of their modifies their self-awareness perception of If and how their presence in ASB training regard to others To explore followed by Healthcare their relationship Professionals with respect to health their professional practice 5
Research Methods Qualitative research based on two types of semi-structured interviews : comprehensive (Kaufmann, 2011) elicitation questioning (Vermersch, 2010; 2012) Interviews conducted with 6 physicians from France having completed their ASB training (500 hours over 4 years) Audio-recorded interviews with each physician (90-105 min. duration) Socio-demographic information obtained, related to the participants’ training and professional activities Data collected in 2012 and 2013 6
Data Analysis Thematic analysis of transcripts Categorisation of themes linked by items and sub- items (Paillé and Mucchielli, 2012) 7
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Participant Profiles: six physicians Participants Year of Age at ASB Training Age at (pseudonyms) graduation and field of graduation graduation practice (medicine) (ASB) Suzanne 1989 27 yrs old 2010 48 yrs old General Practice Marie-Hélène 1992 30 yrs old 2012 50 yrs old General Practice Nathalie 1996 32 yrs old 2011 47 yrs old General Practice Isabelle 1989 33 yrs old 2008 52 yrs old General Practice Philippe 1977 30 yrs old 2008 61 yrs old Cardiology Eva 2007 26 yrs old 2005 24 yrs old General Practice 9
An open door to exploring the Self The Body as a Background Framework ✓ Four types of intervention involving the body forming a unit ✓ Based on the sensorial part of the gesture and the learning potential of perception ✓ The sensory contact of the body, as a gateway to the subjective part of the gesture and transformation of the person. 10
The Quality of their Self-Awareness : Focus on Themselves by the subjective body experience Focus on themselves 11
Subjectivity though the body Anchoring Self-awareness though the body 12
Meta-posture : objectivity 13
A proximity to and a certain distance from themselves and events 14
The Quality of their Self-Awareness (Meta-posture): Process of Awakening to One’s Life, Becoming an Actor in One’s Own Life 15
Their Presence in Regard to Others: Professional Relationships • ASB training Transformation - their Potential for relationship to themselves experiences (subjectivity) that 4/5 Suzanne has made progress in transformed their transform dealing with her depressive state and professionnal has more self-confidence; she has relationships chosen to look on the bright side of life and to listen to her body. Improvement - professional (proximity-distance) 16
The Quality of Self-awareness and Presence to Others « It allows me to ground myself inside More presence and and stay there, to have availability to others a presence to both 6/6 myself and the patient. » Eva « I can now manage 4/6 The right not to be overcome with therapeutic emotions. I can avoid distance taking on the other 5/6 person's distress as if it was mine. » Suzanne More singularity « I believe that every disease has in the patient-doctor its history, and I find it relationship interesting to work at a personalized level. » Nathalie 17
Connection Between Personal and Professional Life: Increasingly in Line With Their Vocational Identity Suzanne : « Et où j’ai réalisé petit à petit que, de toute façon, “I je leam the savais, maisdoctor je l’avais unthat I wanted peu occulté, tole que depuis départ, je voulais faire de la gynéco. Et je me suis donné les moyens d’y arriver. Donc, je subissais ma condition, bepasdeep enfin, professionnelle. Je ne m’y plaisais pas, mais je ne faisais down grand-chose pourinside. en sortir. » So this brings great joy to my life. Really! Marie-Hélène : « Je suis médecin, mais thérapeute; et je suis médecin comme moi je souhaitais profondément l’être. It’sVraiment, Donc là, il y a une espèce de, c’est une grande joie dans ma vie. an amazing gift.cadeau c’est un immense It’s d’avoir a huge réussi à accéder là où je voulais. C’est immense, quoi, parce que j’avais une idée du thérapeute que je voulais être, mais je n’avais pas les moyens. » thing, because I had an idea of the lasort Nathalie : « Déjà, je peux dire que les PS me permettent d’exercer of therapist médecine I wanted de la manière qui me convient. to » J’arrive plus à entrer dans la logique corporelle. Et maintenant avec les PS, c’est plus un dialogue avec le corps de be, l’autre. Il y a un échange, les organes sont vivants, ils ont une but histoire I didn’t et ce have the n’est pas uniquement means un organe to malade ou un organe à traiter. » get there.” Isabelle : « Pour moi les PS sont très importantes dans ma pratique, je ne pourrais pas faire que de la médecine générale parce que je disjoncterais très vite. Les PS m’apportent personnellement un moment de où je me pose. Un moment de calme et de sérénité où je rejoins quelque chose de plus grand que moi. Moi, j’ai besoin de l’écoute, des “I could tissus not et je vois plus practice solely le traitement comme un general dialogue de tissus à tissus. » medicine Philippe : « Les PS because ça répondaitI àwould une attente,gounecrazy demande, quelque chose qui était plus ou moins formulé, informulé, que j’avais essayé de faire il y a une vingtaine d’années, mais donc ça n’arrivait pas au bon moment dans rather ma vie, […].quickly. ASB personally » « immédiatement, c’est là que j’ai découvert, j’ai découvert ce nouveau toucher. Et là, j’ai su que j’étais, allows j’avais trouvé dans la méthode, ce qui me convenait parfaitement, c'est-à-dire l’abord pulsologique du corps humain oume time to go inside de l’être.» myself; a moment of calmness and serenity Eva : « Être sujet, ça s’est venu justement quand j’ai commencé à adopter l’attitude d’écoute des PS dans ma pratique when de médecin I can feel justement où je sentais something le goût dethat isvois, cette chose vraiment identitaire et très incarnée, très moi. Tu concrète, perceptive, etc. Et donc là, j’ai commencé à sentir le bien que ça me faisait aussi d’avoir ce niveau de greater subjectivité than corporellemyself. ” de ma pratique. , […] d’aller favoriser celle (subjectivité) du patient. » dans le temps 18
Conclusion ASB training led participants to refocus inward, thus effecting changes in their personal and professional life. The body seems to be a background framework on which took place transformations in the person, as if the body became an interface that had effects on several personality traits of the participants. Rather than abnegating the body, which is often privileged in medicine, it appears that a quality relation with one’s body allows people to delve deep into their body subjectivity in order to look more objectively at the Self and have a better nature of connexion to it, thus bringing health to the practitioner and his/her professional relationships. ASB appears to be an interesting type of formative practice for the development of certain qualities deemed valuable for health-care professionals. Limits: This study is based on a limited number of cases and is context-specific. 19
Questions 20
Targeted References Bois, D. (2007). Le corps sensible et la transformation des représentations chez l’adulte. Thèse de doctorat, Université de Séville, Séville. Cencig D. and Humpich M. (2009). La somato-psychopédagogie et ses dimensions soignantes et formatrices. In D. Bois, M.-C. Josso et M. Humpich (dir.), Sujet sensible et renouvellement du moi (p.329-345). Ivry-sur-Seine : Éditions Point d’Appui. Duval, T. (2010). Fasciathérapie et transformation du rapport à la santé. Étude auprès de patients suivis en fasciathérapie. Mémoire de Mestrado en Psychopédagogie perceptive, Université Fernando Pessoa, Porto. Kaufmann, J.-C. (2011). L’enquête et ses méthodes : l’entretien compréhensif (3e éd.). Paris : Armand Colin. Large, P. (2009). Corps sensible et processus de transformation. In D. Bois, M.-C. Josso et M. Humpich (dir.), Sujet sensible et renouvellement du moi (p. 403-415). Ivry-sur-Seine : Éditions Point d’Appui. Paillé, P. and Mucchielli, A. (2012). L’analyse qualitative en sciences humaines et sociales. Paris : Armand Colin. (3e éd.) Vermersch, P. (2012). Explicitation et phénoménologie. Formation et pratiques professionnelles. Paris : Presses Universitaires de France. Vermersch, P. (2010). L’entretien d’explicitation (6e éd.). Issy-les-Moulineaux : ESF éditeur. (1re éd. 1994) 21
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