Are you just sitting?

A previous post in this blog indirectly posed a question: does  'slow therapy', an outgrowth of slow medicine advocated by Victoria Sweet and others*, have any place in the modern human service system? Do speech language pathologists have the space and time to, in addition to treating components of the core impairments of bodily function; - to support and nurture all other parts of the person they serve? As the previous post indicated, you may do it - but you should not write it into the record. BUT, yes - you SHOULD do it. Slow therapy can mean better quality outcomes for the persons served. When you use this approach, you may want to signal to the person you are not one of 'the usual suspects'. You do not conduct SLP business "as usual".

Sweet put it this way, describing her encounter in "just sitting" with a patient at the Laguna Honda Hospital (p. 327, paperback edition): "The diagnosis had appeared without me sending her to the emergency room, without additional tests, scans or biopsies. Somehow, just by sitting with her, I'd understood what was wrong. I began to try it with my other patients. Just sitting". She goes on to say that by taking 5-10 minutes to sit at the bedside of other patients, she knows what has to be done.

What, though, is just sitting? Is it replicable? What are the steps to take to accomplish it? How should the SLP place importance upon it, among all the other tricks in her bag? Sweet goes on to describe the experience as "most like waiting for a train in Switzerland...Sitting on a bench, with ticket purchased and in your pocket, knowing that the train will arrive on time; there is nothing more to worry about and nothing more to do". It is the supreme degree of focus that a skilled diagnostician brings to every visit with persons served, because every clinical visit is a behavioral experiment. It is the physical presence that a trained observer like an SLP may use purposefully, to elicit actions or discourse from the persons served: a deliberate "Hawthorne effect".

Every visit with your person served gives you opportunity to revisit the therapeutic alliance, first forged at evaluation and primal to the success of your encounter with that person. There is a time for obtaining major bundles of data from your person, at which time you might receive the nickname "the question lady" or the equivalent. There is also a time for taking in the person's whole, when you are just sitting.

* Quotations are taken from:

Sweet, Victoria. GOD'S HOTEL: A Doctor, A Hospital, and a Pilgrimage to the Heart of Medicine. New York: Riverhead Books, April 2013.