Response of the Patient in the Case Report

As the patient described in the case report by Dunleavy and Kubo Slowik,¹ I want to share that many aspects of the letter² resonate with me. She describes her experience, which has unfolded over the past year, and I am in awe of her intellectual and emotional commitment to this journey. I would like to express my gratitude and focus on 2 aspects of what she has written.

She describes the road to recovery as going “through physical therapy.” The body really is the key here. We both live with posttraumatic stress disorder. We both have memories that come, not from the head, but from deep inside the body. Physical therapy may bring those memories to the surface, or it can re-traumatize.³ The preparation and reactions of the physical therapist are crucial. In both of our cases, our physical therapists encouraged us to seek psychotherapy and followed up on our seeking additional help. The letter writer urged professionals to “keep a low threshold of suspicion for a history of abuse,” and I agree completely. That does, however, raise unanswered questions: How will physical therapists be prepared to deal with such a history? Will physical therapists be able to refer to effective professionals when comorbid conditions are apparent? Will supervisors understand when this process has required more than the usual amount of time? Will insurers be prepared to pay for additional services and additional necessary appointments?

The letter writer also describes how important it was that, in her most uncomfortable moments, her physical therapist would say, “Don't worry, I'll catch you.” As the patient, I can let these fragmented and explosive memories surface only if I am sure that I can trust my physical therapist to do that. I need to have learned that, no matter how jumpy or irritable or unfocused I am, my physical therapist will stick with me and handle it—and not let me get down on myself, either. I need to feel sure that my physical therapist is there to catch me.

• © 2012 American Physical Therapy Association