PYT Graduate and DPT, Tianna Meriage-Reiter pens a letter to the editor of PT Journal, in reponse to an article about "Stress Management as an Adjunct to Physical Therapy for Chronic Neck Pain" Bruflat, et al., 92:1348-1359doi:10.2522/ptj.20110489
Dr. Meriage-Reiter writes,
Initially, it was a pleasure to finally see an article in PTJ that approached the psychosocial aspects of pain.
We know that pain is a sensation that may be brought on by sensing pressure, chemical irritant, or temperature. But what that pain means to us and how it escalates into a chain of mental and physiological processes, can be stoked by psychosocial aspects. So, I thank the authors1 for bringing this up.
However, I was disappointed that diaphragmatic breathing was listed under "psychotherapy" training. Are we as physical therapists not knowledgeable about the autonomic nervous system (ANS)? We know the science behind diaphragmatic breathing and its ability to regulate the ANS by way of its proximity to the vagus nerve, as well as the sympathetic chain. And we are certainly capable of teaching awareness or "mindfulness" of the bodies' physiological responses (muscular tension, rapid breath, actions/reactions). In my education as a physical therapist, these were not taught as adjuncts to physical therapy. These are physical therapy. Ekerholt and Bergland mentioned, "The breathing influenced the therapeutic relationship and therapy outcome. This may be an important subject…to physical therapists in general. Observation of breathing should represent an important part of assessment and treatment in physical therapy. Further development of this useful skill is recommended."2(p839)