My family recently attended the Mother’s Day service at Elevation Church where Holly Furtick preached the “Circle of Hope” from Romans 5:2-4 (“…and we rejoice in hope of the glory of God. Not only that, but we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope”). The gist of the sermon was how our general baseline “hope” ultimately becomes strengthened as we face the struggles in our lives. Every time we emerge from adversity, our hope is more equipped to take on the next challenge. These struggles vary in intensity, duration, and importance, ranging from the small daily annoyances (ex: traffic, paying bills) to a great life-changing event (ex: death of a loved one, marriage problems). During the service, I could not but help to think of the common phrase “that does not kill me only makes me stronger”.
As a mid-30s adult with a wife, two kids, and a career, I certainly have seen and experienced this circle of hope, and I believe in learning from and being strengthened by each challenge. I also believe this is applicable to physical therapy, especially for those experiencing chronic persistent pain or rehabbing after a serious injury/surgery. Let’s discuss further:
Hope: Hope is the patient’s baseline belief and internal strength as they enter the rehab process. This is a combination of personal opinion, past experiences, locus of control, general attitude, current life situations, and many other factors. Basically, the more positive previous experiences they have building hope and strength, the better they are able to take a hit and push onward.
Struggle/Pain: This is the reason they are seeing us as patients and can vary from chronic low back pain to acute ACL reconstruction. Regardless, it will be challenging, unpleasant, and scary.
Perseverance/Endurance: The only way to get through a challenging adversity is by taking it one day and step at a time. Some issues can take the better half of a year or longer to resolve or before the patient can return back to playing a sport. This can seem like a prison sentence to most. To have a successful outcome, both the patient and the provider need to have patience and trust the process. This experience is crucial for character and strength development.
Character/Strength: Character and strength are what emerge from enduring and persevering the struggle. For a chronic pain patient, it may be trust in their own ability to take care of themselves and knowing they are able to have an active life. For the athlete after an ACL reconstruction, it may be heightened sense of body awareness and ways to mitigate future injury. For all, it is the power of knowing they were able to get through it. And all this will feed their previous baseline hope and better prep them for the next flare-up, injury, season, training block, etc.
Though the circle sounds good, we must be aware of the possible consequences of a failed struggle. Either one of two things may happen: 1) the individual learns valuable lessons from “what went wrong” and is able to apply them to future situations, thus actually strengthening their character and hope; or 2) the negative experience feeds into the next struggle, decreasing hope and creating a larger adversity (“making a mountain out of a mole hill”). For example, a chronic pain patient who failed multiple courses of physical therapy and other medical interventions previously may have weakened armor when dealing with a new injury or pain flare-up. This MUST be considered when working with a patient and may require adjusting the treatment plan accordingly.
The Circle of Hope is a powerful weapon helping us fight our battles. Each battle we face, endure, and survive strengthens us for the next one. Because there will always be the next battle, struggle, injury, adversity, etc. The goal isn’t to avoid them (impossible!) but to be ready for them.
As we oftentimes say in the Army, “EMBRACE THE SUCK!” It will spit out a better version of you on the other side.