Healing Is Not a Return to Before, So Hysteresis Is Not the Right Model

In their article, Weisman and Masharawi make an excellent point that injury makes it difficult, in subtle and invisible ways, to return to the pre-injury state: hysteresis. The difficulty isn't the patient's fault: it isn't laziness, hypochondria or malingering, but rather whacked out interoceptive systems. The authors are correct in that. But the place I disagree with them is their emphasis on the return. They say '@#! it is hard to go back.' And they are right about that, too. It is hard. But why are those the only two choices? When they chose hysteresis as the metaphor, they quietly restricted the solution space to two points. The frame I would prefer is 'where you are now, post injury, and what the possibilities are going forward.' As well as offering many possibilities instead of just one, the learn-forward frame drives a different perspective on treatment, attitude and research.