Physiotherapy Otherwise

Intensive therapies: Essence and shadows, Intensities — Re-enchanting physical therapy — Physical therapies are everywhere — Hollowing out physiotherapy — Transforming our teaching — Deschooling physiotherapy — Vernacular physical therapies — Physical therapies in common — Threats to the commons — Physiotherapy as an act of enclosure — All physiotherapy is theft — Neither the state nor the market — From individual rights and inclusion, to common rights, belonging, and abundance — Closing words

Over the course of this book, we have moved from thinking about what the professions are, to the middle chapters focusing on what they are not, and now we arrive at the question of what they might become. The theories we have interrogated have evolved from early structural thinking, through the need for us to consider the role of people’s agency, and on to the problems of how to reconcile competing world views. These approaches have, in many ways, mirrored many of the major societal shifts. And so we now arrive at a moment when social theorists are grappling with how to make sense of the complexity, ambiguity, and uncertainty of life in the 21st century.

In working on this chapter, I was eager to develop a different approach to thinking about the future for physiotherapy than had been offered before. I wanted to be able to answer, as best as possible, the criticisms of physiotherapy levelled at the profession throughout the book (summarised toward the end of Chapter 8), and to address the three critical questions being posed by post-professional healthcare in Chapter 7. To do this, I sketched out five guiding principles to help me think through how physiotherapy might become otherwise. These were:

• Key principles

  Are there any of these five principles that you disagree with, would remove or replace?

  Are there any extra principles you would add?

  That the physical therapies will be vital for human flourishing and planetary health;

• That the professions will be increasingly de-centred in people’s experience of healthcare;
• That decent, compassionate, and socially just healthcare will never be realised by the state or the market;
• That it is the ethical responsibility of all professions that they create the conditions for their own demise;
• And that when the pressures of maintaining a professional enclosure are removed, the latent potential of the physical therapies will erupt.

I suspect that what follows from this thinking will feel, to many readers, like some of the strangest and most challenging ideas they have ever encountered as physiotherapists. I have drawn on concepts, philosophies, and language that only a handful of therapists will recognise. And I have tried to push these ideas to their very limit. I am aware that this might put many readers off. But as I said at the opening of the book, this text was always as much about exploration as explanation, and I knew that any speculation on the future of the profession would always have to stray into unfamiliar territory. I can only hope that the work you will put in to making sense of these ideas is as rewarding for you as it has been for me.

What was strange about this exercise, though, was how easily the ideas came together. There seems to be a natural synergy between them that will, I think, start to reveal itself. And while all of the concepts and practices presented here are speculative, you will see that they are drawn from a wealth of recent scholarship, and from a wide range of contemporary philosophers and social theorists.

I have tried to present them in a way that reveals some of the astonishing latent potential of the physical therapies. But this chapter can only peel away the surface layer of one direction of future travel. The physical therapies ‘bear the lightning of possible storms’ ^[1], and physiotherapists are ‘much freer than they feel’ ^[2]. So, I hope that there is enough in here to stimulate a thousand new inquiries, open physiotherapy up to a thousand new lines of flight, and a thousand ways we can break free from the tyranny of the past.