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How Physical Therapy and Mental Health Intertwine

If we are to truly support and facilitate healing, we must also acknowledge that each system of the body is meant to interact symbiotically and in harmony with all of the other parts.

This is a guest post from the Ketchikan Wellness Coalition and Kelly Chick Comstock.

Physical therapists are not typically considered mental health practitioners. However, we now live in a world which all healthcare professionals must come to better terms with the ever-increasing challenge and need to successfully treat individuals with complex and often chronic medical issues for which there are strongly documented links to personal histories of Adverse Child Experiences (ACE’s). 

Physical therapy is known for helping individuals with issues related to pain, injury, and loss of function. However, many of the challenges confronting physical therapists today include successfully helping individuals overcome poor habits and destructive behaviors which lead to injury and pain in the first place. These include but are not limited to underlying limitations in body awareness, compromised sensory integration, and elevated sympathetic arousal levels in the nervous system from both emotional and/or physical traumas. 

Even challenges in motivation and self-discipline can be due to challenged coping mechanisms for handling the stresses and responsibilities of life. Often behaviors associated with chronic pain, recurrent injuries, weight management, and poor compliance are directly related to mental health issues – because they do not originate just in the body – they involve the nervous system and emotional processing areas of the brain.

In our role as physical therapists, we need to understand this. While we cannot overcome these challenges alone, our role is not to just help individuals mask and overcompensate for these issues. We cannot as physical therapists do this simply by addressing the body part that brought them in our door, we need to attend to the whole person in a compassionate manner, emotionally as well as physically.

We live in a healthcare culture today which increasingly pressures practitioners to compartmentalize their attention to a specific complaint, body part, and diagnosis, attending to only one symptom. There is nothing at all natural about this. Our bodies operate using highly developed systems which naturally interact with one another in a beautiful and amazingly orchestrated way. If we are to truly support and facilitate healing, we must also acknowledge that each system of the body is meant to interact symbiotically and in harmony with all of the other parts. We need to be intentional in understanding how these systems interact with one another to either promote health or prevent it. 

Of course, as physical therapists, our “avenue of entry” to the person is always through the tissue, helping to improve structure and increase function. But the process for each individual can have many possible avenues, and often more than one is needed. No matter how someone comes to us, and no matter what part we play in their healing process, there are some very important things that help make the positive difference in each person’s successful journey back to wellness.

1. Set a clear goal and communicate it.

There is a saying that says, “People are about as healthy as they make their minds up to be.” Each person must decide what they want their health to be, and that decision is so important. As healthcare professionals we can want something great for everyone who comes through our door, but we cannot want it more than they do. If so, we will only create a dependence on ourselves as practitioners, and individuals will never be able to truly achieve success and own it for themselves.

2. Make a commitment to see it through.

“Sweat equity” is not just about getting the heart rate up and burning calories, it’s about going the distance to obtain better health; emotionally, physically, and spiritually; and not giving up until a result is achieved that can be sustained for the long haul. This could mean doing the hard work of confronting emotional abuse just as importantly as sticking to a new exercise routine. It could mean identifying a toxic relationship and finding the strength to move on. Or it could mean admitting powerlessness over an addiction and seeking help to overcome it.

3. Be willing to sit with the discomfort.

Many patterns in our bodies that have become dysfunctional could have developed as survival mechanisms and may no longer serve us. In order to make changes and minimize negative consequences, we need to honestly confront and feel the pain of where we are now before we can do something different. Those who become willing to take this step can find solace in the well-known recovery slogan, “This too shall pass.”

4. Build a team of support.

Too often those who deal with chronic pain and health issues are challenged to find people in their lives upon whom they can reliably depend. It’s kind of like looking for love in all the wrong places. Here the wise sage’s advice could readily apply: “When the student is ready, the teacher will appear.”  This could very well come in the form of a supportive boss or colleagues at work; a pastor and church fellowship; a counselor or sponsor/mentor in a recovery program; or even an understanding family member and group of friends. It has been said that “It takes a village to raise a child” but I would take it even further, and go so far as to say, “It takes a community to grow an adult.” When we attend to all aspects of ourselves; not just the physical, but the mental, spiritual, and emotional parts as well, with the help of others, we will always have a more ‘Optimum’ chance for success!

Kelly Chick Comstock

Kelly Chick Comstock (PT, CST, CBIS) is the owner of Optimum Health and Wellness Physical Therapy, Inc. in Ketchikan, Alaska. She is a techniques-certified CranioSacral Therapist and certified Brain Injury Specialist dedicated to providing personalized and holistic healthcare to the community of Ketchikan.

Healthy Minds is a monthly column coordinated by Ketchikan Wellness Coalition as a way to share positive stories from people living with mental illness, offer information from local mental health professionals about maintaining mental health in your life, and provide details on tangible activities or actions you can take to strengthen your mental wellness. If you would like to contribute to the column, please contact Romanda Simpson at

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