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Two physical therapists walk into a bar…

By Noigroup HQ Metaphor and language 02 Dec 2016

The comedic process

I love hearing about the process that comedians go though to develop their material. What comes off as spontaneous and surprising is actually carefully crafted through an iterative process of evaluation and improvement. Interestingly, the process of becoming funny involves telling a lot of jokes that aren’t funny at all.

However, by paying close attention to the audience, all of those failures can lead to refinements in the jokes, the transitions and the timing. The result is a set that they know is going to make the audience laugh. Once it’s fully developed, they make it look easy.

Here’s Jerry Seinfeld on writing Pop Tart


Rambling and repeating…

I remember after my first Explain Pain course, I came back to the clinic with all this science and all of these wonderful analogies.  It was going to be great. I enthusiastically fumbled through it with a few patients. I rambled. I repeated myself. I talked around the topic. I was so busy trying to remember what the hell I was saying that I forgot to pay attention to the bored and confused looking person I was saying it to. 

In comedy terms, I bombed. I bombed and I rapidly become demoralized. 

I’ve found that this is one of the main barriers to clinicians confidently and successfully using Explain Pain. Like with many continuing education courses, the excitement of the weekend begins to wear off by Wednesday and by Thursday you’re back to your old clinical habits. 

In a funny coincidence though, shortly after attending the course, I came across an article about how stand up comedians build their material. How they fail. How they make note of the failures and the little successes and improve the delivery, timing and the jokes. 

Here’s Amy Schumer on the worst she ever bombed and how she handled it


Fail, fail again, but keep pushing on

I thought about it and realized that it would be no different for me. I was going to have to endure some failure and some eye rolls from my patients. 

So I pushed forward. I observed. I got better at figuring out how ready a patient was to take in the information, when I needed to gently use analogy to break down the walls of cognitive dissonance. I got better at using the analogies that I had learned, figuring out which one the patient needed to hear and even developed some of my own. I got better at pacing the material so that the poor patient wasn’t overwhelmed in my excitement. 

Worth getting good at

It turns out that Explaining Pain is just like everything else worth getting good at. Before you get good, you are probably going to have to suck for a while. But if you can endure the frustrations and put in the work while paying attention to the needs and responses of your patient along the way you will be well rewarded and your patients will reap the benefits. 

If you’re an experienced Explain Pain-er and had to struggle a bit to get to that point, feel free to share your story in the comments. 

-Cody Weisbach

Cody is a Physical Therapist in Boulder Colorado, with a special interest in pain. Cody can be found on Twitter @CodyWeisbach and he’ll be at EP3 in Philadelphia December 2-4.


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