Every so often we profile a member of the Critical Physiotherapy Network to find out a bit more about them and their work. In this ‘interview’ we asked Wenche Bjorbækmo about the inspiration behind her research. Wenche works in the Institute of Health and Society, Faculty of Medicine, University of Oslo. Wenche’s work centres on qualitative research, phenomenology, physiotherapy, movement, experience, exercise, disability and (re)habilitation (you can see a link to her interests, research, teaching and publications here). Wenche has been a member of the CPN almost from its inception, and many of us had the pleasure of meeting her and hearing her present at the In Sickness and In Health conference in Mallorca in June.
Where does your interest in children’s rehabilitation and particularly their lived experience come from?
Not so easy to say. I think it has been a kind of process during my life, also before I became a physiotherapist. I have always loved listening to people telling stories about how they have experienced certain situations and so on. And I have always had a desire for movement – not for exercising as such – but for the joy of running, jumping and the pleasure of balancing on the fence around the playground and hanging upside down by my legs. When I was educated I started off as a physio at a hospital and was especially drawn to working with people with different kinds of neurological disorders. I was challenged by how their way of moving was different and how I had to think in other ways than ‘normal’ movement development. Gradually I saw that whenever someone was asked to go to visit the child in room so-and-so – I was the one that went. Another reason why I got involved in childrens’ rehabilitation is because of an interest in children’s way of being and playing – I think they are very wise people. They have important things to tell and I have so many times been surprised by their reflectiveness and insight. After working at hospitals with both adults and children, I got a job as physio for children in the municipality were I lived and was lucky to get the opportunity to build up services for children and adolescents. Since then I have worked with children and their families.
You talk about the importance of movement improvisation in your paper ‘’My own way of moving’ (link). Can you explain how you came to think about this idea?
In a way I think I have always been practicing movement improvisation in combination with the more common movement instructions in my work (also with adults), but it was as a PhD student that I went to a course about movement and experience at the department of health sciences at the University of Oslo. Gunn Engelsrud was the head teacher and the invited teachers were two dancers from USA educated in contact improvisation. That week on this course was, if not a turning point, then a wake up call. I decided to explore my own movement experiences and signed up for an evening class for adults at the School for Contemporary Dance in Oslo. I was the oldest, the stiffest and yes – I felt different, and in a way I felt happy with it – because I could experience being a ‘strange’ mover. I kept on for a couple of years doing this course. What struck me was how welcomed I felt even together with professional dancers I felt as a creative competent mover. Another phenomenon from participating in these classes was that I started to dream about moving. I remembered I had such dreams as a kid, but it had been years since I dreamt I moved. So you may say these moving experiences with the other participants and the teachers moved me towards not only exploring movement in the classes, but in my life.
I understood they also had classes for children and asked if I could observe and follow a couple of these classes. I was allowed to do so and spent one autumn observing children (without any known or obvious disability) moving in these improvisation classes. Soon I realized that this way of moving together and exploring and teaching in movement had some special possibilities. With the openness and willingness to see opportunities that the young dance teachers showed, I realised that this way of “teaching in therapy” would also do for children with disability. Then I asked for and got some more funding for my PhD project and hired two dance teachers and organized a one-year movement group with twelve children, and explored the potential of improvisation in physiotherapy. Improvisation is not as unusual or as special as we often think, we all improvise all the time, but seldom think of it.
In your paper ‘Experiences of being tested’ (link) you say that ‘Regular testing may result in insecurity on the part of the tested individual, and possibly to a lack of confidence in their body and the way it functions.’ Do you think this has implications for areas of physiotherapy other than children’s rehabilitation?
Yes, I do think this is common for all of us – we feel very deeply about being tested, especially when we do not succeed. We are all being tested in different ways throughout our lives. Health and school systems are maybe extreme in testing people, but we also test others and ourselves in our daily life. So in a way it is part of our being. What I am upset about is the increase in professional testing. I do think in physiotherapy it is important to emphasize how little you get to know about someone through the use of all the different questionnaires and outcome measures that have been created, designed, developed the last decades. What I also find important, decisively important, is how all these standardized tests downplay the competence of a sensitive, skilled, reflective expert practitioner. We have to use these testing with care, consideration and respect for the person being tested. I believe it is crucial what Gordon Stobart highlights saying that being tested should inspire the one being tested to further efforts and not result in discouragement and a sense of failure.
What appealed about Merleau-Ponty’s phenomenological approach to the embodiment of lived experience?
Again a really big question. Reading Merleau-Ponty’s philosophy inspired me to pay attention to the value of the experiential side of movement and life. That was most important to me in the beginning. Through reading phenomenology l also come to understand that the way we move is not only related to the kinds of bodies we are, but always also related to the environment, the situation, our circumstances, and things as well as other people, animals… whatever constitutes our environment at certain time and space.
How did you find the experience of completing your PhD thesis in 2010?
Hard work with glimpse of wonderful insights that made me keep on and enjoy being able to dwell and think for months, even years.
Whose work has influenced you most in recent years (who would you recommend others read)?
For some time I have been reading Jean-Luc Nancy’s books: Corpus – it really makes you think. Also his book Being singular plural, as well as Derrida’s book: Touching Jean-Luc Nancy. Very, very interesting – and also hard to the get grip of. For those who want to read philosophy, phenomenology of the body and existence – these are books I can recommend. Some days ago I read this article: Jazz and the “Art” of medicine: Imporvisation in the Medical Encounter, written by Paul Haidet in Annals of Family Medicine. I read it through with a bigger and bigger smile on my face – read and enjoy!
What advice would you give to physiotherapists interested in the forms of movement you have advocated recently in your papers?
To read and learn some more about the experiential side of moving and movement. I would recommend they read Maxine Sheets-Johnston’s book: The primacy of movement. J. Merleau-Ponty writes a lot of movement, and the moving subject in his book: Phenomenology of Perception. I also recommend Samuel Tode’s book: Body and World. The authors are philosophers, but their theories about body and movement are essential to physiotherapy, at least in my opinion.
What are you working on at the moment?
For some years I’ve been working in a research program, researching physiotherapy in primary care, limited to private clinics in primary care. The project I have and still work with has aimed in different ways to examine individually adapted physiotherapy; effect and experience. Yesterday, we had a closing seminar with the funding organization Fond til etter og videreutdanning av fysioterapeuter and the collaborators in the program; the University in Trondheim (NTNU), the hospital Diakonhjemmmet Sykehus in Oslo, and collaborator clinicians. I will continue working with these papers and also be a member of the research group working with FYSIOPRIM 2 which also has got funding from Fond til etter og videreutdanning av fysioterapeuter (The Norwegian Fund for Post-Graduated Training). I also have worked on an article based on data from my PhD project, it will be sent to ‘language wash’ as we directly translate language editing. The title is: Physiotherapy with children, knowledge in translation – what knowledge counts? I will also work more as a teacher at the master program at Department of Health Sciences, University of Oslo – especially, what I am looking forward to is to teach qualitative method during the Norwegian spring of 2016.