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26 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 1 "June? Really?" As soon it came out of my mouth, I realized my response was a bit forward. (OK, maybe a lot forward.) "Yes, that was the first available appointment I could get with the hand specialist," she replied, while I tried to walk back my reaction. The context? My client, Ms. M., is enrolled in a master's program in flute performance. She is likely to pursue a doctorate as well; playing the flute is both her passion and her future livelihood. How is it that a musician of her caliber must wait four months for an appointment? Given my experience in treating collegiate athletes—who have access to treatment immediately—this made no sense. This fact only strengthened my determination to help her recover as quickly as possible. As I began to address the musculature in her forearms, I could sense a question brewing from the concerned look in her eyes. "Is this something that will pass, or is this a problem I will have to deal with my entire career?" Ms. M. asked. Her question cuts to the heart of the struggle that affects most everyone in pain. It isn't just what you feel, it is what you think it might mean for the future. For anyone to experience arm pain is unpleasant. For Ms. M., the thought that this pain could alter her life path is potentially devastating. Playing the flute since age 6, her arm pain is now also a threat to her personal identity. It is here that pain and stress share particularly important attributes. One of the factors that can increase the experience of both pain and stress is a sense of uncertainty. Pain (and stress) that is predictable or best practices | TABLE LESSONS Excellent Questions Honestly Answering Clients is the Best Policy By Douglas Nelson knowingly short-lived is much easier to tolerate than pain that may be chronic. In the research arena, unpredictable pain is experienced as more unpleasant, harmful, and intense. Even more, losing control over pain is worse than having never had control over it in the first place. Ms. M.'s question expresses her desire to have a sense of what to expect in the future, so that she appropriately might address it. Addressing a question such as this is never easy. We therapists are often understandably hesitant to predict possible outcomes. Yet, responses like "every person is different" is of little help to the client. How do we respond honestly and accurately to such a difficult but important question? After pondering her question, I answered in the best way I knew how.

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