Why Your Client Doesn't Need A Perfect Plan - Just a Habit

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Transcript

Lindsey: 

Hey, everyone, welcome back to the OTs for Public Health podcast. I am so glad you're here. Today's episode was sparked by a conversation I listened to just this morning.

It was an interview between Emma Greed, who I've talked about on this podcast before, so inspirational. And James Clear, you may have heard of James. He is the author of Atomic Habits.

 And if you read the book or even just heard the phrase, you may be a little bit familiar with the idea behind it. Basically, it's about how small, consistent actions compounded over time really lead to big, meaningful change. 

Now, as I listen to their conversation between these two brilliant people, I kept thinking this is pelvic health.

This is literally what we do every single day in the clinic, in home health, in a postpartum visit. We are working with people whose bodies are asking for consistency, not perfection. Their recovery isn't lean linear.

Our clients are trying to relearn how to trust their breath, their bladder, their bowels and their pelvic floor. 

So today I want to explore just how we can bring James Clear's habit strategies directly into our work as pelvic health OTs.

And by the way, this is not just for clients, but for ourselves, too. 

Intro:

New and seasoned OTs are finding their calling in pelvic health. After all, what's more ADL than sex, peeing, and poop? But here's the question. What does it take to become a successful, fulfilled, and thriving OT in pelvic health? How do you go from beginner to seasoned and everything in between? Those are the questions and this podcast will give you the answers.We are inspired OTs. We are out-of-the-box OTs. We are Pelvic Health OTs.I'm your host, Lindsey Vestal, and welcome to the OTs in Pelvic Health podcast.

Lindsey: 

All right. Here's a line that James Clear repeats a lot.

 And I got to tell you, it really resonates with me. Every action you take is a vote for the type of person you want to become. 

I love that.

 I'm going to say it one more time. Every action you take is a vote for the type of person you want to become. Because in pelvic health, we often work with people who don't feel like themselves anymore.

 They say things to us like, I used to be active or I feel broken or I don't trust my body now. And our job isn't to fix them. It's to help rebuild that connection one step at a time, one action at a time.

 Let me give you a quick example. So I recently worked with a postpartum client who had a second degree tear, and she was really fearful around movement. She told me she felt overwhelmed and didn't even know where to start.

 Well, we didn't start with Kegels. We didn't start with a whole home exercise program that was 50 minutes long. We started with two minutes of diaphragmatic breathing while she was nursing.

 That's it. Two minutes a day. She anchored it to something she was already doing.

 And over time, that one habit turned into gentle pelvic tilts on the physio ball as she rocked her baby. Then we went on to gentle core engagement. Then we talked about body mechanics and the quintessential squat when she's bending down to pick up her baby and how those micro movements matter and how she could feel organized in her body again as she bent down to pick up her baby and she could do it with ease.

 Three months later, she had more of a movement routine that looked more like a movement routine that she felt proud of. Because she then had the window where she felt like she could take that in and accomplish it. But it started with two minutes.

It started with believing in herself that she could do those two minutes. And we scaffolded it every single week, sometimes every two weeks. Sometimes we, you know, I met her where she was.

 But three months later, I think we were up to like a maybe like a seven or eight minute routine that she did. But we kept the habit stacking with everyday things she was doing with baby. And she loved it.

 This is the power of small habits, right? 

They're not just exercises. They're identity building. They're little votes for I am someone who prioritizes my healing.

 And that is huge. 

Another powerful idea that James Clear talks about is this. Don't focus on what you want to achieve. Focus on who you want to become. 

And when I heard that, I thought this is the missing link in so many rehab goals.

 So often we're asking our clients to aim for outcomes. No leaking daily bowel movements. 

And yes, those are important. And they're also just data points. They don't always get to the deeper identity work our clients are doing. 

So what if instead of saying I want to have a bowel movement every day? A client says, I'm someone who listens to my body's cues.

 Imagine a client with chronic constipation. Maybe they've tried all the fiber, all the stool softeners. Still, they feel stuck.

 But when they start anchoring to the identity of someone who moves with ease or someone who supports their body with compassion, those little shifts can completely change how they relate to their habits. And guess what? The same thing goes for us as clinicians. Are we trying to be more organized? Are we becoming people who honor our time and our energy and our boundaries? 

Identity based goals help us create habits that last because we're not just changing behavior.

 We're changing how we see ourselves. 

Now, the really cool thing about James Clear is he's got these, this framework. It's called the four laws of behavior change.

And here they are. 

Number one, make it obvious. 

Number two, make it attractive.

 Number three, make it easy. Number four, make it satisfying. 

All right.

 Let's translate this into pelvic health OT. Number one, make it obvious. 

If your client is struggling with breathwork, what if they placed a sticky note on the bathroom mirror that says exhale, right? A tiny prompt that makes that habit visible. 

Number two, make it attractive. Can we associate pelvic care with comfort instead of dread? Maybe your client uses lavender oil or soft lighting during a perineal massage, or maybe they do their stretches with their favorite music or they anchor their breathwork to a cup of warm peppermint tea.

 We want to shift these things from, oh, I've got one more thing to do today to this is a moment I give to myself. Right?

Number three, make it easy. Now, this one is big. This one is really big. If your client only has five minutes, totally OK.

 I actually love my clients that are that transparent and say, yeah, five minutes is about all I've got. So instead of maybe a beautiful 20 minute dialed in movement progression that you've used before, give them one movement, one glide, one bridge or try habit stacking. Right?

 After I brush my teeth, I'll do one pelvic tilt. Simple, doable, habitual. 

Last up, make it satisfying. All right. As humans, we are wired for reward. So how can we help our clients feel good after doing something helpful? That might mean checking off a box, journaling one sentence, or maybe just noticing how they feel more grounded after a breath.

Remember, satisfaction reinforces behavior and your client's identity. 

All right. There is this other idea that James Clear shares, and that is you don't need to be perfect. You just need to show up. I love this one. 

Sometimes we get caught up in the all or nothing mindset.

I know I do. And if we can't do the whole routine, why bother? Right. But let me ask you this.

 What if we just did one thing. Right? I remember I had this postpartum client in New York City who was exhausted. She had two kids under actually under one and a half.

 She told me, I only have the energy for one bridge a day. I said, fantastic. Do that. So she did that. The next two, maybe two weeks later, she did two bridges. Then she added breath work.

 One year later, she was running again, not because she went hard, but because she stayed steady. And that is the magic of consistency. Reduce the scope.

 Stick to the schedule. And honestly, Boutis, we need this advice, too. If documentation feels overwhelming, open the EMR and write one line.

If you're behind on notes, start a timer for 10 minutes. Small action can lead to big momentum. Now, if you end up listening to the interview between Emma and James, there's this one moment that Claire says, never let a day go by without doing something that benefits your 10 year self.

I paused the podcast right there because for me, that really hit something deep. 

In pelvic health, we often think long term, right? We're supporting clients who maybe don't want to have surgery or live pain free in menopause or want to be able to pick up their grandkids without leaking. 

So I started asking myself, what is one thing I can do today? Just one that benefits the version of me 10 years from now. 

And I'm going to start asking my clients this, too. What can you do today that supports your future pelvic health? I think this is an important question because it's more than a physical action. It's actually a mindset.

What is one thing you can do that will make your life easier for yourself in 10 years? That might look like prepping your eval notes now instead of later or setting up the next visit before you close the chart. It doesn't have to be big, but do it today.

OK, so let's bring this all together. Whether you're working with someone healing from a third degree tear, helping someone manage prolapse or navigating pelvic pain. 

Remember, your job is not to fix them. Your job is to help them build a system, a rhythm, a way of caring for themselves that feels possible. And honestly, we need that, too. As clinicians and as humans.

 So here's a few micro habits I've been playing with. I'm curious if any of these resonate with you. 

Number one, after a client finishes a breath, I ask them, where did you feel that? After I finish a session, I close my eyes for 10 seconds before jumping into the next one, and after I document, I jot down one sentence of what I learned today about myself.

Now, these are tiny things. But. I feel like they're going to help me stay grounded, curious and connected, so I'm going to leave you with this question.

 What habit do you want right now that will help your future self? And how can you ask your clients to do the same? 

Thank you so much for being here. If you enjoyed this episode, please, please, please leave me a review, particularly on Apple podcasts. If you can, it helps to spread the word.

It helps to let folks know about what we're doing in this incredible field of pelvic health, sending you so much love.

Outro:

Thanks for listening to another episode of OTs and Pelvic Health. If you haven't already, hop onto Facebook and join my group, OTs for Pelvic Health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and post it to IG, Facebook, wherever you post your stuff, and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic Health podcast.