This online interview originally appeared in August 2000 on the complimentary care website OneBody.com. The interviewers are “OneBody Kate” and “OneBody Nan.”

<OneBody Kate> Good Afternoon and welcome to OneBody's Special Guest chat!

<OneBody Nan> Today at OneBody.com we will be chatting with Kate S. O' Shea MA, the author of 'Healing Hip, Joint & Knee Pain: A Mind-Body Guide to Recovery from Surgery and Injuries'. Kate will discuss creating a precise, compassionate, and practical approach to orthopedic conditions. Kate has a Masters degree in psychology and 20 years of body/mind awareness and movement training and practice including the Rosen Method, Eutony, Educational Kinesiology, and Yoga. Kate is in private practice in Sausalito, working with people recovering from mobility problems, chronic pain, and orthopedic surgery.

<OneBody Nan> We'd like to invite the audience to submit questions to today's guest. Thank you for joining us today, Kate. Would you like to tell us about yourself and how you became interested in the mind/body field?

<Kate S. O'Shea> I became interested in the world of mind/body therapy due to my own personal condition and being able to share what I have learned with other people. I was born with a dislocated hip and had several surgeries as a child which were unsuccessful. When I was 13, I had a partial hip replacement. This was a very radical thing to do in 1968. But, I did have a relatively good result. Although I still had limited mobility and some
discomfort.

<Kate S. O'Shea> When I was in college I became interested in massage primarily because I was stressed out due to my schoolwork. However, that led me to start on a very important path of self-discovery. What I found was that with the experience of massage I discovered a lot of fear and emotional tension in my body. As I began to work through that, my comfort, my mobility and my stamina began to improve. As I continued to explore mind/body awareness and movement therapy my whole sense of self was strengthened as my body was stabilized.

<OneBody Kate> So, really, your first experience with your own situation is what led you to come to the conclusion that this mind-body field would work for others?

<Kate S. O'Shea> Yes, my private practice in the last 20 years has confirmed that for me.

<OneBody Kate> dsmcw: I've heard that hip replacements have a 'shelf life' - that many people will have to have a second replacement after a decade or more. How have you managed to avoid this, since you had your operation so long ago?

<Kate S. O'Shea> That is a very good question. To be specific I have a middle hip socket, not a total hip replacement. However, I am confident that what I have learned is relevant to any joint replacement situation. First of all, in terms of the statistics, it is very important to remember that they are looking at a broad range of people including elderly people, people who have other illnesses, people who are quite overweight, all of which can contribute a shorter "shelf life". In addition, the medical technology has improved over the years so that the types of procedures being done now are addressing some of the earlier problems. Hip replacements and knee replacements are being done on much younger people now. There is a real opportunity to get the most out of the doctors' good work. That is what I have been focusing on in myself and with others.

<Kate S. O'Shea> From a mind/ body perspective, one of the first things I talk with my clients about is what do they think about their 'new part'. People can feel a little squeamish about it and have a tendency to distance themselves from that part of their body. What we have learned from biofeedback tells us attention brings with it circulation which is critical to the healing process. So, I encourage people with any sort of new "part" whether it is a hip joint, knee or heart valve to really welcome that into their bodies - to feel that it is truly a part of them now, to imagine the blood bathing the new part, the bone and soft tissue knitting around the prosthesis. I think this was a major part of my success because I had had my metal hip socket for about 12 years before anyone suggested that I might need to have it replaced someday. So, I really encourage people not to plan on 2nd and 3rd replacements. They do not have to buy into that. It does not have to apply to them.

<OneBody Nan> If you have just joined us, we are speaking with Kate S. O' Shea MA, the author of 'Healing Hip, Joint & Knee Pain: A Mind-Body Guide to Recovery from Surgery and Injuries' about creating a precise, compassionate, and practical approach to orthopedic conditions.

<OneBody Kate> Annemarie: It seems like having a joint replacement would require both physical and psychological adjustments. I would also imagine that these issues might be even more complicated for young people who are facing other developmental challenges. Have you found this in your practice? What are some of these issues?

<Kate S. O'Shea> Yes, what I am seeing most in my practice are people who are about 50 years old who have been extremely active, real athletes, whose joints have worn out. The first issue they have to deal with is recognizing that they have to slow down. The body is not indestructible. In some people, they take this as an opportunity to really deepen their relationship with themselves. They use the process of preparing for surgery and their rehabilitation as a way of developing mindfulness.

<Kate S. O'Shea> When I am working with someone who is learning to walk again, a great deal of attention is required to regain the natural fluidity of movement. This is a great opportunity to become more present in general. In terms of kids, I primarily have to speak from my personal experience because it is quite unusual for joint replacement to occur in a child. But, I have found that the issues of standing up for oneself, supporting oneself, feeling a sense of safety in the world are all related to one's sense of physical stability and mobility.Older people face these issues to a lesser degree, I think, but they do come up either because of pain before surgery or just general weakness after surgery. They may experience this sense of vulnerability because they are physically vulnerable for a period of time. This dynamic led me to coin the phrase 'Orthopedic Psychology' which really seeks to explore the interaction between one's physical experience in the world and one's emotional experience in the world.

<OneBody Kate> How long do you think it takes the average person to learn how to manage their pain and/or problems through mind-body techniques?

<Kate S. O'Shea> It is very individual. It is much easier if you work with a practitioner who is skilled in helping people approach their pain gently and carefully. The work that Jon Kabat-Zinn has done at the University of MA is a very good example of this approach.

<OneBody Kate> Aliesse: Are there many orthopedists who address these kinds of issues with their joint replacement patients?

<Kate S. O'Shea> Unfortunately not, I have found in speaking with orthopedists they are highly trained in the medical technology but are really not able to take the time to think about or address these issues. Many orthopedists have not experienced joint surgery. It is very hard to understand the experience unless you have gone through it.

<OneBody Kate> Tom: I have just had a hip replacement 2 years ago and am interested in this mind-body field. Where do you think I should begin?

<Kate S. O'Shea> I assume that if you are asking this question you are not happy with your result.So, to begin with, it is very important to keep moving after a surgery. The healing process is supported by movement and to become comfortable and stable again you need to regain your strength. First off, I would encourage you to either swim or walk within your level of comfort so that you gradually build up your strength to address the mind/body side. To address the mind/body side I would encourage you to look for a massage therapist first who you can talk with specifically about your surgery. Look for someone who is experienced working with pre-operative patients with the goal in mind to increase your sense of connection and ease with your whole body and your hip specifically.

<Kate S. O'Shea> Sometimes, after surgery we develop tension that restricts our movement and can even create pain. I could also refer you to my book 'Healing Hip, Joint and Knee Pain' for a more in depth discussion and some very practical and simple movement therapy.

<OneBody Nan> If you have just joined us, we are speaking with Kate S. O' Shea MA, the author of 'Healing Hip, Joint & Knee Pain: A Mind-Body Guide to Recovery from Surgery and Injuries' about creating a precise, compassionate, and practical approach to orthopedic conditions.

<OneBody Kate> Lance: Do you find any resistance from the orthopedic doctors in using mind/body therapy in conjunction with conventional treatment?

<Kate S. O'Shea> Actually, I have been surprised at the general supportiveness of doctors.They are a little mystified, but they can also see the logic. I have not encountered resistance. One thing I work with quite a bit is preparing people for surgery and there are some wonderful tapes people can take with them into the operating room. Also, some people are asking their doctors to say positive things to them while they are under anesthesia. In general, the doctors have been pretty willing to go along with these things. In fact, research is showing that this kind of preparation and support through surgery can even improve the
outcome.
<Kate S. O'Shea> I would refer people to the work of Dr. Emmett Miller, who can be reached at: www.drmiller.com. Also, Peggy Huddleston, her book 'Prepare For Surgery, Heal Faster'. Basically, patients are leading the way here and I have found that when doctors see positive results they are happy.

<OneBody Kate> Aliesse: In your book, what specific mind/body practices do you recommend for people as a starting point? Especially people with no previous exposure to this kind of thing.

<Kate S. O'Shea> I would start with a process that was really the beginning for me. Sit quietly in as comfortable a position as possible. Gently rest your hands in a friendly way on the part that hurts. Take time to be quiet with that part of you that has been 'creating the problem'. The homework assignment I got was to 'love' my hip. What I discovered was fear and anger. You might discover something else. But, to begin you want to gradually build a more positive sense of connection with the part that has been painful. I have found in myself as well as with my clients that this simple thing can bring relief on a variety of levels. Sometimes, we have been so disturbed by the
physical pain that we actually exacerbate it with further layers of tension. This simple extension of a friendly hand to yourself can begin to unravel that.

<OneBody Kate> Well, this has been very interesting, Kate. Thank you for your insight into the mind/body connection. Do you have any final words for our audience?

<Kate S. O'Shea> I would encourage people to have an open mind toward their recovery and to be curious. Be thoughtful in exploring what can help them personally. Trying new things in a careful way has been very helpful to me. People can learn more about my book on my website: www.orthopedicpsychology.com . They can email me at: kate@dnai.com or phone: 415-331-9041. On my website, I have a variety of other resources that can be quite useful to explore.

<OneBody Kate> Information on mind-body work can also be found on OneBody.com in the Healthy Library.

<Kate S. O'Shea> My article 'Walking With Comfort And Confidence' will be linked to this chat transcript and possibly available in other areas of the OneBody website. That article offers some very practical methods of thinking about how you walk-- from understanding how your skeleton is designed to support you to some useful and playful and things to remember that can make your walking easier.

<OneBody Kate> Thank you so much for joining us and thank you to our audience for coming!

<Kate S. O'Shea> Thanks for having me!

<OneBody Nan> We'd like to thank Kate O'Shea for joining us today and sharing her insight. OneBody.com would also like to thank our audience for joining us and for participating in today’s chat. If you would like more information regarding today’s topic, you can find out more in OneBody.com’s Healthy Library. Transcripts from today’s chat will be available on OneBody.com in the coming days. While you are visiting OneBody.com, join the OneBody.com Connect Community. Join our discussions on dozens of topics in the forums and in our active chat rooms! Learn more, share more, with the OneBody.com community!