In the second part of this series we discussed the fact that we must learn to simplify our vocabulary if we want to better communicate with our patients. In this part III we will discuss Apperception.
Apperception is the process of interpreting or understanding something by the help of past experience.’ We actually use this technique on a daily basis without even knowing we do it. Imagine that we are talking to a child and we are describing a dinosaur, something they have not yet seen before. How would you describe it to them? You might begin by describing how big it is by pointing to the height of a two story building. You describe the neck by showing the trunk of a tree. You might describe the legs like those on an elephant. Then you can show the person something that is gray if that is the color. You point out the tail by using your hands and showing its length and width. You are actually using something already known (past experience) to help them understand something they do not know or have not experienced.
Practical Application of Apperception
What can we do similar in a report of findings? Some examples of describing the size of the nerve might be using a small coated wire. You might explain the numerous fibers by showing what is under the coated rubber of the wire. Describing ligaments or connective tissue that has some stretch to it can be demonstrated by using a rubber band or thera-band. The three phases of motion of a joint can be shown using your finger. The pinching of a nerve can be demonstrated with a rubber band around your finger and cutting off the blood supply. The weight of the head can be shown by an old bowling ball. There are numerous things we use to teach something through apperception.
Explaining the Non-Tangible
How can we explain the non tangible things? I was very impressed during a health care talk when I first saw a doctor describe innate intelligence and complete nerve flow without interference when he used a light. It was bright and shiny. Then with a small turn switch he began to slowly turn it down so it was not perceivable to the naked eye. Little by little, without anyone in the audience noticing it was being reduced in its brightness during the lecture. Finally at the end of the class he asked the audience if anyone noticed any change in the light and nobody did. But, when he turned it up to its complete brightness they were surprised how bright it got. Then he explained that this was the same way we lose our health and get nerve damage. It is not perceivable until it is in the last stages of disease in which we then have symptoms to alert us of the problem.
There are other non-tangible things that people need to learn such as trust’ in the doctor. We can have other patients with similar problems share their testimonies of chiropractic care and the skill of the doctor to these patients. Telling a patient it will get better requires some faith. By having testimonies of patients written up and placed in books in the reception area will help with this intangible. It is even more powerful when you place patients near each other in the therapy room and introduce each other. You don´t have to share what ails them. They will do that automatically! And, they will brag about you and your service.
Can you think of other intangibles that you need to teach? Just apply it to the something tangible. One renowned educator says that when you teach an intangible just say something such as ______ is like ______’. Trust is like __________’. Fill in the blank. Trust is like a seed. If the seed is good it will begin to grow. If it is not a good seed it will not grow.’
Since patients come to doctors they need to trust them. The seed (trust) begins to increase when the patient feels a decrease in symptoms over time with their treatment. Trust can also be demonstrated when the doctor performs a re-exam and the patient sees many of the positive objective findings changing to negative findings.
In giving reports we have many opportunities to use the like’ phrase to help people understand. The pain that you just experienced yesterday is like a person who just got a toothache. It took years and years for the enamel to wear away and now the sensitive nerve area is exposed and this person feels the pain. Your back is like the tooth that aches. It didn´t just happen. It took years and years for you to reach the point of feeling this pain.’
The cause of your problem is not because you bent down to pick up the pillow. Your back has been like a camel. You have heard the saying ‘it was the last straw that broke the camel´s back.´ Well each day one more straw was added to the camel´s back until it broke him. He was fine until that last one. You have been fine with all the things that you have done in your life. But, all those actions like sleeping wrong, smoking, bending, slouching, working out in the yard are like the straws on the camel´s back. When you bent over to pick up the pillow, it was like the camel´s last straw. So you see it started a long time ago.’
There are just so many likes’ we can use to teach. The disc is like a hockey puck.’ The fluid in the disc is like a thick jelly.’ The cartilage is like the gristle on the back of a turkey bone.’ The ligaments, if not injured are arranged in fibers elongated like string cheese.’ When the tissue repairs itself with cells it gets thick like scars you have seen and it becomes less elastic.’
Don´t confuse your patients with complicated words and phrases of which they are not acquainted. Learn how to use what they already know to make comparisons so they understand and learn. Do this and you will have created another teacher of your craft who can send you more patients.
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