This is a perennial question in my head as a practitioner. Why does someone take the time and energy to seek out my work and then not return after their first visit or a couple of visits? As one of my Anatomy in Motion mentors puts it ‘why people don’t come back’ is an interesting foray into human psychology. From what I’ve heard from clients, other practitioners and my mentors, there’s a few reasons behind people falling off the radar after their first session or a few sessions. Here is my contribution.

1- People don’t like change

Seeing me results in change. Change for the better, perhaps, or change for the worse. Change, nevertheless. This is a curious reason not to return. Changing something that is ‘bad’ or ‘painful’ or ‘holding you back’ into something less bad, painful or limiting should be a positive. However, there are a number of reasons why change for the better might be scary. Some people have identified with their pain or limitations for so long that once they change how they feel they may have to do things they aren’t actually prepared to do. They may have to change into a person that actually does the things they’ve always identified with not being able to do because ‘it hurts’ or ‘I can’t’. Similarly, committing to the work required to change may not be something they are prepared to invest in. Changing something requires a bunch of effort or a large shift in mindset or habit forming and if we’re not prepared to put in that effort then we are comfortable with not changing.

2- Everyone wants to be better but few want to do the work themselves

One of the many hats I wear at the clinic I work at is front desk staff. I manage the schedule for a few dozen practitioners. Many of our regulars are seeing a massage therapist, chiropractor or acupuncturist once a week, every week for an entire year. Often for many years in a row. Think of how much time and effort that is. 20 minutes to an hour, once a week, every week for a year, plus the commute time and the time spent booking the appointments. That’s a LOT of time and energy. I’m not saying these patients don’t want to get better. But they have chosen to spend all of that time and energy getting someone else to keep their issues at bay for a few days at a time. They’d rather have someone else keep their pain at bay than invest the time and energy themselves in unraveling the root cause of their pain. It’s not that these practitioners don’t give the patients tools to keep the pain away. I hear them all give home care advice that will help the patient manage or reverse their issues. In fact, one of my other roles at the clinic is physiotherapy assistant. Most of my patients do their home care. Those that do them get better. Those that don’t, just don’t. The practitioners themselves get frustrated that the same people come in every week with the same problem, they don’t do their home care and the practitioners are bored! They wish their patients would do their home care so they can move on to treat someone else who needs them. If we truly want to get better then it takes effort and patience to get to the root causes of your issues. When someone comes to see me and they discover what it will require to get better sometimes they just want to go back to the other modalities they’ve been using to keep the pain at bay.

3- People get overwhelmed with what they have to do

A frequent response I get to a first session is ‘I didn’t realize things were so bad’ and ‘I can’t do anything you’re asking me to do’.  They go home and stop doing the homework I gave them. Then, if they come back, they reveal that they were overwhelmed by how many things they need to work on. I had one client tell me ‘I gave up because there are so many things I didn’t even realize I need to change about my body and I got so overwhelmed. This is not the right time for me to work on my body.’ Often we want to make a change in our bodies and we get started only to find resistance. Our bodies don’t do what we want them to do. It doesn’t feel the same as when they’re with me. They get lost in the details. If they can’t do it perfectly, it’s not worth doing at all. So many excuses we can make to stop us from simply getting started and making incremental progress. We are also bombarded with messaging that problems get resolved quickly. The mystery that gets solved in a 1 hour TV show. The miracle cures that make problems vanish for $49.95. Or the problem gets worse. You came in for a sore knee and now your feet ache. That bit of resistance has us doubting whether we actually want to change or improve the problem. So people give up and stop trying.

4- People are already ‘perfect’ and being better is not a priority

Perfect is an interesting word. By definition is means ‘complete’. We are all ‘complete’. Your way of getting from A to B is complete. You got there, somehow. That’s as perfect as you can be in the body you’re working with. Sometimes someone comes in and we resolve their problem enough that it’s no longer a problem. Or it becomes less of a priority than other ‘problems’ they need to deal with in their life. Being better than ‘it no longer hurts’ means they are perfect. Being better than ‘the other things that are a bigger priority to solve’ is also perfect. When those issues start knocking on the door and they have no choice but to pay attention to them, perhaps they’ll return to the work.

5- Things get worse and they balk

Life is like a cha cha dance. Two steps forward, three steps back. Nothing in life follows the beautifully straight path that we see in movies or shared by people who succeed. It always follows a circuitous path. In fact, life is more like a spiral. We keep finding ourselves circling back to the same situations we thought we’d moved on from. Often I’ll have a client make some progress on their problem only to find that something gets worse. Or an old injury suddenly begins to bother them once we’ve made progress on the main problem. Or they have a setback. Or they are sore from the exercises and want to rest. When we work on the problem often it is a challenge. And we may not be prepared to face the challenges involved in improvement. Things were bad enough having to manage this pain to begin with. We just aren’t prepared for the setbacks involved in the process.

6- They want it done faster (and yet they never get better)

For some of us, we want a quick fix. This is another thing we are sold on all the time. Take this magic pill, buy my vibrating foam roller pad, crack this joint and all will be better. But things are rarely this neat and tidy. If I tell you that it’ll take 6 months to 2 years of daily work to rewire your very stuck in movement pattern and get you out of pain. Or it may take many sessions for us to clear out the clutter and find the actual cause of what’s going wrong in your body. Many people will just jump on Yelp and find the nearest and cheapest person who makes claims that they can fix you faster and cheaper. It’s human nature to want fast results. But fast results rarely stick. Just like those patients who come back week after week for massages and feel good for a few days and then hobble back in the same time next week, change takes time and effort. And nobody can predict how much time and effort that might take. Often when someone goes to the faster and cheaper practitioner, they end up coming to me many months later and tell me it’s not gotten any better.

7- "I feel stupid when I ‘can’t’"

I had a client say this to me one day: ‘Do you like being smart? Because I think of myself as a very smart person but when I am in this room my body feels really dumb.’ Sometimes it’s uncomfortable to discover spaces of lack in our bodies. We go about our lived experiences making assumptions about who we are. It isn’t until someone holds a mirror up to us that we discover that we might not be who we think we are. The body that gets us around every day actually has a lot more deficiencies than we are even aware of. It’s uncomfortable to have our flaws exposed, assessed and critiqued. Often we don’t even know we have those ‘flaws’ and assume we are more complete and competent than we are. To have someone point out your deficiencies when you’re already feeling vulnerable from your pain can often prevent someone from wanting to return and continue the work.

8- Revealing trauma that we’re not prepared to face

Our bodies store a record of every experience we’ve had in our lives. Clients come to me to look at something that hurts. Often pain is a result of the body negotiating a way to get you from A to B after an injury has made it painful to move the way you used to. Working on the site of an old injury will bring up the trauma of the injury in some way. Many of us completely forget about that old ankle sprain, or falling off a moving vehicle or banging your head really hard on that low doorway. It isn’t until we start moving the part that was injured and locked down by your clever, protective nervous system that the uncomfortable memories of the accident come back. Trauma is uncomfortable. When we move the site of the old injury it can bring back a lot of feelings, memories and experiences that we’d shoved down and conveniently forgotten about. Whether we are aware or not of our bodies deleting our memories of these events, there will be resistance to going back to that dangerous area of our bodies. Our bodies will do everything in their power to not experience that same bad event. They will even make you cancel your next appointment with me because not moving that scary, injured part is a matter of survival. Often I will start working on the site of an old injury and there will be pushback. Initially the client is enthusiastic about getting to the root cause of their issues. They walk out the door excited to book their next session. And I never hear from them again.

9- It’s fixed!

The final reason may be that we got lucky and ‘fixed’ it in one or two sessions. I don’t pretend to be skilled enough to be able to solve anything in an hour. Nor do I think there is any modality out there that can ‘fix’ most people in one visit. (If there was, robots would have taken our jobs already.) But it’s possible that someone came in for a minor issue, I got lucky being able to pinpoint their issue and they walked away achieving what they hoped to achieve. Go ahead and look at my testimonials and you won’t see a single one where someone came in once and didn’t need to keep doing their homework or come in to keep troubleshooting the root cause of their pain. But if we get it right quickly, then the client won’t come back. In my experience, once we resolve the main issue and the client is happy with their new-found freedom from pain, they are motivated to fix ‘all the other stuff’ we discovered in their first session.

 

What do all these reasons have in common? Mindset. Humans are fallible. We get in our own way. We think we know best until we come up against an obstacle. We think we know what we want until it becomes challenging. We think we know ourselves until we find out we don’t. Our ego keeps us safe, or ignorant, or stuck. We are impatient, near-sighted, and fearful. When someone holds a mirror up to us we shy away or deny that what we see is the truth. We aren’t prepared for what we might discover about ourselves or how to manage our own tendencies to fall back on habits or break promises we make to ourselves. We are sold the notion of quick fixes and simple, tidy solutions when life almost never is that straightforward. And we’re busy. Busy getting from A to B in a way that isn’t bothersome for us or busy avoiding what should be more urgent. Bodywork is part technical skill and part mindset management. Why didn’t someone come back? It may be more about them than about you and your abilities as a bodyworker.