86 Transforming our teaching

Hollowing out physiotherapy can also take another, more critical form, if it accounts for the layers of unseen prejudice, stigma, and injustice that are part of the patriarchal, normalising, and othering practices of all orthodox professions in the Global North ^[1]. There is little doubt that education can be ‘a modality of freedom’ ^[2], but, as Alexander Jones argues, it can also be a tool for curating and restricting knowledge, ‘brain-washing’, and socialising people into cult-like obedience with troubling ways of thinking and acting ^[3]. Education can be ‘a hotbed of injustice and power imbalances’ (ibid).

Physiotherapists can no longer be party to the social ‘waste-sorting’ ^[4] that modernisation and economic progress have foisted on the professions. Bauman argues that Western societies have created many kinds of ‘waste’, including waste people (people we have cruelly marginalised in society: migrants, disabled, racialised, women, queer, elderly, etc.), waste goods (money, consumer products, time), and waste matter (pollution). And the economies of the Global North have depended on the professions, including physiotherapists, to manage these ‘superfluous’ elements in society, and ensure that they do not impede the West’s growth and prosperity.

The response of health professionals in the West, has largely focused on developing practitioners’ ‘analytical, evaluative, synthetic, and logical’ thinking skills ^[5], in the hope that these will allow professionals to analyse clinical data, diagnose underlying pathology, and rationally synthesise information. Arno Kumagai and Monica Lypson argue, though, that because medicine is a social practice, the ‘development of critical thinking alone may lead to great technical skill without an accompanying understanding or ability to effectively address health-care-related issues confronting society’ (ibid). They call instead for greater critical consciousness (see Chapter 4), so that health professionals can better understand ‘differences in power and privilege and the inequities that are embedded in social relationships’ (ibid).

Our new theorists approach this demand differently. By working to strip away the layers of unseen prejudice, stigma, and injustice from the physical therapies, we allow ourselves to become, in Deleuze and Guattari’s term, ‘minoritarian’ ^[6]. Becoming minoritarian is a deliberately molecular political strategy, quite different to the grand, ‘molar’ structural politics of Marx and critical theory. It is an act of stripping away the dominant social discourses of science and reason, the biological body as source of illness, the primacy of biomedicine, objectivity, detachment, and reductionism. It rejects prevailing norms and the will of the majority. It is the active casting off of power, and opening the physical therapies to deterritorialisation, metamorphosis, and uncontrollable movement.

Deleuze and Guattari argued we should be becoming-woman, becoming-animal, becoming-queer, becoming-other, becoming-multiple ^[7]. Becoming minoritarian is to rid ourselves of the patriarchal, humanist fantasy that we are ‘makers of worlds’ ^[8], and recognise instead that we are ‘defined by precarity’ (ibid); that we are always ’unfinished, open-ended, perpetually in process’ ^[9], and using this knowledge as ‘a riposte to the timeless, absolute status of official ideologies’ (ibid).

Reframing physiotherapy education in this way is to embrace something of the liminal and fragmentary nature of the physical therapies. It opens practice and thought to more choice, more diversity and inclusiveness, and less power and control by institutions like the professions, the state, and corporate markets. It is to enact ‘cooperative alliances, aggregations of conviviality and affinity at the level of society that materially deform the state power that threatens to saturate them’ ^[10]. It is to embrace the idea of physiotherapy as one option for people among many, rather than perpetuate our ‘special pleading about how society as a whole would benefit’ ^[11], if there were more of us and less of ‘them’.