On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Shelly Prosko on the show to discuss compassion in healthcare. Shelly is a physiotherapist, yoga therapist, educator and pioneer of PhysioYoga with over 20 years of experience integrating yoga into rehabilitation with a focus on helping people suffering from persistent pain, pelvic health conditions and professional burnout. She guest lectures at yoga and physiotherapy programs, presents at medical and yoga therapy conferences globally, provides mentorship to health providers, and offers onsite and online continuing education courses for yoga and health professionals. Shelly is a Pain Care U Yoga Trainer and maintains a clinical practice in Sylvan Lake, Canada. She is co-editor of the book Yoga and Science in Pain Care: Treating the Person in Pain.
In this episode, we discuss:
-Can compassion be trained?
-The six elements of Halifax’s model of enactive compassion
-Empathic distress, compassion fatigue and burnout among healthcare practitioners
-The five facets of comprehensive compassionate pain care
-And so much more!
Resources:
Prosko PhysioYoga Therapy Facebook
Yoga and Science in Pain Care: Treating the Person in Pain
For more information on Shelly:
Shelly Prosko, PT, C-IAYT, CPI, is a Canadian physiotherapist, yoga therapist, author, speaker and educator dedicated to empowering individuals to create and sustain meaningful lives by teaching and advocating for the integration of yoga into modern healthcare. She is a respected pioneer of PhysioYoga, a combination of physiotherapy and yoga.
Shelly guest lectures at medical colleges, teaches at yoga therapy schools and yoga teacher trainings, speaks internationally at yoga therapy and medical conferences, contributes to academic research, provides mentorship to healthcare professionals and offers onsite and online continuing education courses for yoga and healthcare professionals on topics surrounding chronic pain, pelvic health, compassion and professional burnout. Her courses and retreats are highly sought after and have been well received by many physiotherapists, yoga professionals and other healthcare providers. She is a Pain Care Yoga Trainer and has contributed to book chapters and is co-editor and co-author of the textbook Yoga and Science in Pain Care: Treating the Person in Pain by Singing Dragon Publishers.
Shelly is a University of Saskatchewan graduate and has extensive training in yoga therapy and numerous specialty areas with over 20 years of experience integrating yoga therapy into rehabilitation and wellness care. She considers herself a lifelong student and emphasizes the immense value gained from clinical experience and learning from her patients, the professionals she teaches and the colleagues with which she collaborates. She maintains a clinical practice in Sylvan Lake, Canada and mentors professionals who are interested in pursuing this integrative path.
In addition to her many skills as a healthcare practitioner, Shelly is also an accomplished figure skater and has traveled the world with many professional ice shows. She is passionate about music, dance and spending quality time with family and friends. Shelly believes that meaningful connections, spending time in nature and sharing joy can be powerful contributors to healing and well-being.
Please visit www.physioyoga.ca for more info and resources.
Read the full transcript below:
Karen Litzy: 00:01 Hey Shelly, welcome to the podcast. I am excited to have you on. This is going to be fun today.
Shelly Prosko: 00:07 Thank you for having me. Really excited to talk about this.
Karen Litzy: 00:11 So I spoke to your coauthor Neil a couple of weeks ago, talking about your book, yoga science and yoga and science and pain care, treating the person in pain. And I'm really excited to dig into sort of your writing within this book because you are writing about compassion. So before we get into the nitty gritty, what is compassion? How do you define it?
Shelly Prosko: 00:41 So believe it or not, there actually is not one agreed upon definition. So that's the first thing is some people describe it as a trait. Others say it's more of an emotion. Some people say it's like a motivation or behavior. But the definition that I use in my chapter is the one that is kind of the working definition that the leading compassion researchers use in the Oxford handbook of compassion science. So that's kind of like the compendium, the Bible of all the thought leaders and researchers around compassion. So that definition, the working definition there is basically compassion is first and foremost. You have to be able to recognize that someone is suffering or struggling or in need. And then the second component is then we have to have the motivation to want to do something about it to alleviate or to help. So basically recognizing the suffering with the motivation to relieve and that is not just us and someone else that's also within ourselves. So compassion also includes the self compassion piece and that is I think really important for us to keep in mind.
Karen Litzy: 01:56 Yeah, I was going to say, and would you say that having compassion for yourself allows you to be more compassionate towards others? Do you feel like it's a prerequisite for compassion as a healthcare provider?
Shelly Prosko: 02:13 That's a really good question. From my perspective, I think it helps. The more self-compassion we have, the more compassionate we can be for others. But the research is kind of right now from what I've been reading, actually, I just listened to a recent podcast a couple of days ago and with a couple of the leading researchers. And there still is no really solid evidence that increasing self-compassion translates to increased compassion for others or that increasing compassion for others translates to increased self-compassion. That said, there is some research that shows cultivating self-compassion does seem to help increase compassion for others. So we have a bit of research that says that. And my own personal view would be yes, I don't know if it's a prerequisite, but I have noticed in my own self without making this like a therapy session, I have noticed that I scored quite low on self-compassion and I have traditionally been quite, you know, self critical and hard on myself. But as I've learned more about this stuff and practicing self compassion, what that is and, and exploring it and experiencing it, I feel like I overall am just understanding more of what compassion is. And I feel like maybe I'm, you know, more compassionate. It could be just age and stuff too and experience, but that'd be my answer to that.
Karen Litzy: 03:46 And why is compassion important in the care of people in pain? So how does it benefit me as a healthcare provider to understand compassion? When I'm working with people in pain.
Shelly Prosko: 04:02 Yeah. So I just want to be clear that sometimes people equate, you know, just being compassionate, they just equate that to being kind, you know, and it's just should be common sense and just don't be a jerk. You know, a lot of people just say, well just, it's not that hard. But, you know, there it is a little more nuanced than that. And just going back to your question on, you know, what are some of the benefits if we actually look at the, the deeper layers of compassion and which I can get into a little bit there later, but the components that go into offering compassion and also self compassion towards, you know, yourself. Lot of the research shows, I mean, stuff that we're not probably really surprised at. Like it can increase quality of care for our patients, increase patient outcomes, increase patient satisfaction, increase therapeutic Alliance, and increased patient self care.
Shelly Prosko: 05:04 So I want to just briefly talk about this cause I think it's really important and we don't think about this part of compassion, but there's this one study that I talk about in the book chapter and it was an entire year long. It was in an integrative rehab hospital and it showed there was a hundred women who are living with chronic pain and it showed that it was only once these women actually experienced what it was like to be loved, cared for, to be seen, to be heard. In other words, to have actually to receive compassionate care. Only then could they take active steps towards their own self care, which I think is really important in pain care because so often we talk about how important it is for our patients to play an active role in their pain care. We're always talking about that.
Shelly Prosko: 05:55 The literature says that we're trying to help our patients make healthier choices, et cetera. And now we have some research that says, well, you know what, if we provide this very in depth, nuanced, compassionate care, it looks like people that are patients are then more likely to, you know, better make better choices. And it's neat. Some of the women, what they were saying, things like they felt worthy, they felt loved and yeah, worthy enough to be cared for. And I just think all of that is so fascinating. So those are some of the, you know, the benefits to providing compassionate care, but there's also benefits to us as the healthcare provider. So what some of the research is showing is that it can actually help protect against burnout.
Shelly Prosko: 06:51 We can dive into that a little bit later too in some of the myths, you know, around too much compassion. But, you know and also just overall the positive health outcomes are increased in us as the health care provider and even things like reduced anxiety, depression, even stuff like reduced medical costs and errors and malpractice claims. Like this is just what all the research is saying. But then I think the other part of it that I do want to really highlight is the self compassion piece. So there is benefit for the person in pain to practice self compassion is what some of the research is showing us now and there is also benefit for us as the healthcare provider to practice self compassion. And again some of that for us as a healthcare provider is like reducing burnout, reducing excessive empathy, which they're calling, you know, empathic distress or empathy key things like that.
Shelly Prosko: 07:49 It helping us improve our emotional resiliency and like we said, potentially even increased concern for others, but in the patient, and this is what I thought was so fascinating as of now, I think there's only about five or six studies out there, but they do show that people in pain that either have higher self compassion or some of the studies actually show people in pain. Doing these self compassion practices actually can show reduced pain severity, reduced anger, reduced psychological distress or things like depression, anxiety and even increased pain acceptance. You know, we know there's some benefits. Especially with the ACT, acceptance commitment therapy research, we're starting to see how that's important and, you know, there's even some links to reduce pain catastrophization and rumination and decreased fear avoidance behaviors. And it's just really fascinating. And I think, just the last bit here on that, on that question is increased self-compassion has been shown to reduce our own self criticism and increase our motivation to actually change our behaviors.
Karen Litzy: 09:02 We're just talking today, Nisha mind who's a psychiatrist. And we were just saying, man, how hard it is to change behaviors for human beings. Cause she was talking, she has a dog. And how with a dog, you know, you can change behaviors by motivating them through food. So they have these incentives or incentivize through food. Humans, it's a little bit harder how difficult it is to change behavior in a human being. So now if compassion and practicing self-compassion can help with behavior change, how do we change compassion? I mean, how do we train compassion? Can we train it?
Shelly Prosko: 09:47 Yeah. So the literature says yes, it is trainable and we have quite a bit now and there's different programs and different styles. And I think, you know, there's a lot of different models and I think probably just to make it easiest for us here as I'll talk through this one model that I really like. It's Joan Halifax and she's an anthropologist and a meditation teacher and a few other things. But she has a really nice model of inactive compassion. And what she talks about is, you know how I said the definition of compassion was in recognizing the suffering first and then having the motivation to alleviate it. She actually goes beyond this and she says that definition's a little bit limiting because compassion is actually more of a dynamic emergent process. So it's more of a wisdom that emerges within the context of the environment that we're in, which makes sense.
Shelly Prosko: 10:53 If you know anything about systems theory or emergent theory and you know, so if we're in a room together with our patient, you've got the patient not person in everything, they're dynamic, you know, evolving system right there in that moment. And then there's us, we're also a dynamic, evolving system that we come together in the context of the environment. And that even changes the dynamic or influences. So compassion can emerge from that interaction, from a series of elements that are actually non compassionate in and of themselves. So we can train and these six elements, and again, this is Halifax's model, but we can train these six elements and it saw like you just train one and then you train the other. It's not linear there, you know, it's like I said, an interdependent integrative process. But I think it's just really fascinating because this is something accessible and tangible.
Shelly Prosko: 11:53 And in the book I go obviously into depth and I'll just try to keep this short. But the first element is the attentive domain. So that's just being fully and wholeheartedly a hundred percent present and you can, we can cultivate our focus or concentration ended up and our attention through a whole host of different ways. Whether it's different mindfulness practices or focused concentrative activities. So that's a whole other way to cultivate that. So just by cultivating and practicing the attention is one way to help the process of compassion. And then the second one is the affective domain. So that is being aware of our emotions and we have a lot of research that shows the more aware we are of our emotions, the more aware we can be of others.
Shelly Prosko: 12:52 And then we also have research that shows some interoceptive awareness practices, believe it or not because of the way something with the insular cortex, you know, we don't know if it's that more information is being sent to the insular cortex or it's just changing the way the brain is interpreting this. But when we do enter in an interoceptive awareness practices, it seems that that increases our ability to be more in touch with our own emotions, which is super cool. So an Interoceptive awareness practice might be like a body scan. So you're taking yourself, we're guiding a patient through, you know, a two minute, you know, scan of the body and inside and what are inside physiological state is like, it could be even, you know, a breath awareness practice.
Shelly Prosko: 13:47 And just knowing how that feels inside the body. And then the third element is intention. So in yoga, that of course, you know, that's my framework, how I frame a lot of things. But in yoga, there's a saying, you know, where your intention goes, the energy follows. So, from a science perspective, when you can actually focus and concentrate on something that you really put, have an attention to it that can affect the outcome. So for example, the intention when you're working with someone might be first and foremost my intention is to care for myself first. Secondly, to then care for the person in front of me. And then you may just want to keep that in mind throughout the whole session. And your intention may be something really specific. Like, I am here to serve, you know, when you sort of keep repeating that to yourself, I'm here to serve, I'm here to serve and my intention setting can be super powerful.
Shelly Prosko: 14:54 I don't know if you've done any intention setting before, but you just set an intention. It doesn't even have to be related to our professional career here. Just even personally, you go into a room or a setting where you're feeling like you don't really want to be there, et cetera. Maybe a family Christmas dinner. And if you go in with this intention, okay, I'm just going to focus on, and you could say anything, I just want to be present or I'm just gonna focus on being kind to myself. And you just focused on that one intention. It's like a theme. So that's the third element. So remember, all of these are now together. They start to accumulate into gaining more insight into the person's suffering in front of you, which then can lead us to have a more compassionate response.
Shelly Prosko: 15:40 Then the fourth element is insight. And that's basically just the idea that these first three components together and practice can lead to that deeper insight into what that person is, you know, is really going through. And then the other part to that insight, I just want to add, cause I think it's so fascinating once we start gaining deeper insight into all this stuff, we do start to understand that there's something called therapeutic humility, which is this idea that, you know, we can't control the outcome. So we do the best that we can. We gain as much information as we can. We be the best people we can be and we help the person as much as we can. And then we detach from outcome and we can pay lip service to that and we can all understand that. But when it comes down to it, I think a lot of us are attached.
Shelly Prosko: 16:38 And we're invested in making sure that the outcome is a certain way. So we could talk about that for a long time. But this is huge in part of the compassionate response is this idea to have this insight that we have to have this humility that we're not the almighty savior and we can't control. And then the last two are embodied and engaged. And so the embodied domain is really this idea that we are fully, fully present. So kind of similar to the first one, but this one is more that we are dividing our attention. Meaning we yes, we have to listen fully and be fully present for the person in front of us. But we also have to stay within our body and not detach from what we're experiencing and disassociate. So we have this idea that we can still feel if our breath is tightening or if there's tension in our body and that can give us a lot of information as well.
Shelly Prosko: 17:37 That's really important. So that's part of the compassionate process. And then the last one, the engaged domain that's really compassion in action. So that's your compassionate. And I think for here, this one, I think the biggest take home message for me has been, it's obviously informed by everything I just said. And it's different depending on the context. So there's no, well there's no GoTo, this is the strategy or this is my response or this is what I say, you know, when my friend is struggling and where someone's giving you some bad news and there's no really go to response, you can have some ideas of course, and then some things maybe that aren't, we want to stay away from saying, but it's really important to understand that compassion is this wisdom that emerges in that situation and the engaged part might be not saying anything or not doing anything. It could be just holding space. And so I hope that helps you and the listeners sort of get a deeper appreciation for this process and that we can train it and that it takes time and it can be extremely helpful for both the person in pain.
Karen Litzy: 19:01 Yeah, I think that's great. And thank you so much for going into a little more detail there on that model. I think it makes it a little more concrete for myself and certainly hopefully for the listeners as well. And now I think something that people may misunderstand or misconstrue is the idea of compassion and empathy as being the same. So my question is there a difference between compassion and empathy? And if so, can you kind of give us the similarities or differences there?
Shelly Prosko: 19:39 Yeah. So just like compassion, empathy does not have one agreed upon definition either. So this makes it challenging to talk about this stuff because you know, people have different ideas as to what these things are. So some, you know, of what I've read about empathy, it depends if we're talking about cognitive empathy or emotional empathy, behavioral empathy. So that makes it a bit tricky. But I'm going to stick with the empathy that I find most people resonate with and that is more that the empathy where it's our capacity to be able to share the feelings of another person. So what it's like to be in the other person's shoes, right? To resonate with their experience, even to share that emotional experience. So if we use that definition, then we know we can see that empathy is really more of a competency.
Shelly Prosko: 20:43 It can be a motivating force for compassion. But what the literature shows is that empathy is neither sufficient nor required for compassion. And you think about that for a moment. It makes sense because we can have empathy for someone. So we may emote, be able to, you know, really understand and emotionally share that same experience or share that same feeling because we've had a similar experience. The response may not necessarily be a compassionate one and there's lots of different reasons as to why we would or wouldn't. I go into a little bit of that in the book, but just I think, I hope that makes sense to everybody. How you could still have this empathy but maybe not provide of a very compassionate response. The other part of that is you don't necessarily have to even have empathy in order to provide a compassionate response. And I think that's actually quite hopeful. And you know, cause I think even talking to some of my colleagues who some people may feel that they're not as empathetic or they've been told that they don't have, what you don't understand.
Shelly Prosko: 22:05 And, you know, the good news is you may not be really empathetic or you may not consider yourself an empath, but you can still have a compassionate response. And I think if you go back to the Halifax model of all of those elements, you know, that help us provide a compassionate response. Empathy can be part of that. Like you say, it can be a motivating factor, but not, no, not the only factor in it. Certainly, it could still be lacking. You could still be compassionate.
Karen Litzy: 22:40 That is hopeful for people who may be feel like they're not as empathic as they would like to be. But like you said, that Halifax model is this sort of emergent model by having all of these different inputs go into the system and have, you know, an emergence of compassion from you. So it's not like all of those parts need to be equal.
Shelly Prosko: 23:03 Right? And empathy. Like I said, empathy can be good. Of course. You know, just think of a time when you shared someone's experience feeling, you know, or their experience. You've had a similar experience that may help us give us an idea. But we also have to, I think this is interesting too. We also have to look at the fact that sometimes if we have empathy and we can really share that feeling if we're not careful and if we're not in this more clear kind of state. We may actually start to look at our experience and what we went through and put on someone else, like almost feeling that, well, this is how I felt. So they must feel that too. And there's something that Paul bloom, he's a psychologist at Yale, he calls it empathy arrogance or the arrogance of empathy.
Shelly Prosko: 23:56 And it's just fascinating. Some of his work and you know, this really made sense to me when he talks about the fact that can we truly, truly have empathy, you know, on that deep level of what it means. Because that means that we want really understand and share 100% with that person is going through. And we can't do that really, if you think about it. And it could be, you know, someone may be that we've had a similar experience, or it could be, think of yourself as a healthcare provider. Look at all the patients we have. I'm coming to see us who are very, very different from us. Different things have happened to them, different socio economic status, people who are maybe vulnerable populations marginalized. And if we're in a position of privilege, how can we truly empathize with some of the issues and the things that they're going through that may affect their esteem? So that's kind of a tangent, but I think why I brought that up. I think it's important is because it's just this idea that we can still be really, really compassionate and we can train for these compassionate responses even if maybe we can't fully empathize. So I think that was the point of me bringing that up.
Karen Litzy: 25:22 Yeah. And I think in my mind, it kind of takes a load off of me as the healthcare provider. You know, that you don't have to have experienced what your patient has experienced in order to provide compassionate care in order to have that therapeutic relationship in order to help that patient in some point of their recovery. So I think it takes a little bit of the pressure off of the healthcare provider, which may in turn help us to be better providers. So we don't have that pressure, like you said, that pressure on us for outcomes because perhaps, you know, you don't want to think, well, because I never experienced it that I can't help this person right now, I'm away or I'm not the right person for you, or something like that. So I think it's an important distinction. And now in the book, in your chapter you sort of have this model of comprehensive, compassionate pain care five sort of points to that. So can you speak about that model of compassionate pain care?
Shelly Prosko: 26:42 Yeah, so really just looking at all the different orientations of compassion. So Paul Gilbert, this is based on Paul Gilbert's work, he's another compassion researcher in the UK. And he talks about the orientations which is giving compassion and then obviously we also receive it. And then the third orientation is the self-compassion within us. So the five components that I see when you look at the full comprehensive, compassionate pain care. The first one is of course what we've talked about here, the health care provider providing compassion. And then the second component is the health care practitioner and the person in pain, cultivating or practicing self-compassion. Oh, that's within each of us. And then the third one is also close family and friends, cultivating compassion towards self and others, including the person in pain. And then the fourth is that we want to make sure that the values of the healthcare organization, including its leaders are in line with compassionate care.
Shelly Prosko: 27:54 So this includes a commitment to providing and supporting an environment where compassion can be cultivated by both the healthcare provider and the person who, and I think that's, you know, just really important to include in a comprehensive model here because it's not just about the healthcare provider and the person. And then the very last point is just the community at large. You know, I think it's important to have overall public awareness and understanding, you know, surrounding the importance and the health benefits and practices of compassion. And then of course, that includes the person in pain. So that's a little lofty and I don't have a task force or a plan or not this, you know, right now I'm focusing on those first two and I'm doing a lot of different things and this is going to be my life's work, Karen.
Shelly Prosko: 28:47 Like I really believe in this stuff. And, I think increasing pain literacy and increasing compassion literacy are two things that, you know, I'm in it for the long run and so how that looks on how we increase pain literacy and compassion literacy in, you know, interest in the general public and in healthcare organizations. I mean, that's a huge topic. But, you know, there are some different things that I've been involved and just with, not necessarily with compassion per se, but just increasing pain that I've seen, you know, our health care community and yoga therapy community. So yeah, to me it's got to be comprehensive like that.
Karen Litzy: 29:42 That's the way you're gonna make, I think a worldwide impact, certainly on those living in pain when we know, at least here in the United States, and I think this is probably can kind of be generalized to other parts of the world. But here in the United States, the burden of care for just low back pain and neck pain is number, I think three or four behind heart disease, like diabetes. So we're talking about pain as being one of the largest burden of care in the United States. And I would argue probably across the world. I don't know that it's that much different or there's that much difference from other parts of the world. I don't know what it's like in Canada, but I mean it's a lot of money. It's a lot of time. It's a lot of resources. It's a lot of relationships. It's a lot of people in pain contributing to that burden, behind those big numbers of trillions of dollars. They're individual people. And so if adding something like compassionate pain care can help make even the tiniest dent in that, then I think it's, I don't think it's a lofty goal. I think it's just a goal.
Shelly Prosko: 30:58 Yeah. I'm glad you say that and you put that into perspective, which I appreciate and yeah, and I think that, you know, just overall this compassion what we've been talking about here, like I think it's the foundation of pain care or is this foundation of health care. You know, you can't really argue with that. And, I don't think anybody would argue with that. But what I think we just don't quite understand is that we may have good intentions and we may think that intuitively, yes we are compassionate people, but the research shows that it can be lacking in certain areas of the world and certain regions, healthcare regions. And also there are fears and blocks and resistances to compassion. Like there are actually reasons why we may not offer a compassionate response. And, you know, some of those reasons are the organizational barriers or different social pressures.
Shelly Prosko: 32:05 But some of them may also be certain beliefs that we have that compassion may not be the best response for this person. Maybe we have a deep seated belief that the person needs something different. You know, there's a lot to this, but there are different obstacles. And also just our own health. I didn't really talk about this in here, but you know, we might be overwhelmed by stress in our lives or we may have some unmanaged personal distress and we have research that shows we don't need research to tell us this, I don't think, but we do have research that shows when our own physiological state is not regulated. When we're in a state of flight or stress or a sense of anxiety, things like that. Neuro, biologically we are not set to provide a compassionate response.
Karen Litzy: 32:59 Go figure. Yeah, that makes a lot of sense. All right, what would you love for the listeners to take away from this discussion and then we'll get into where people can find you in the book and all that other stuff, but, what would be your big takeaway when it comes to compassion and care?
Shelly Prosko: 33:25 I think the biggest takeaway that I would like people to understand is that being compassion is not just about being nice or kind or a good person, so that we could still be all those things, but we actually may still be lacking in that compassionate wisdom. So if you can just think of it more than that and that we could, Oh, maybe get a little bit more skilled at developing this compassionate wisdom. And I guess this is more than one takeaway, but that would be the one. And then just knowing that there are these benefits, both the people in pain and also for us as the practitioner for our own health and yes, for burnout and things like that.
Karen Litzy: 34:18 Now where can people find more information about you, what you're doing and where the book is?
Shelly Prosko: 34:24 So my website's probably the easiest, kind of the one stop shop. So it's physioyoga.ca like Canada. And you know, if you want to sign up for my newsletter from there, it's on my blog. And then that keeps you up to date. Cause I do online courses, webinars, onsite courses, lots of videos, YouTube, you know, all kinds of different resources and things. So, and then the social media links are all on my website.
Karen Litzy: 34:54 Yeah. And we'll have all of that to up on the podcast under this episode at podcasts.Healthywealthysmart.com so people can one click and get right to you.
Shelly Prosko: 35:04 Okay. Yeah. And then the book, the co-editors, you've already mentioned Neil Pierson and then Marlisa Sullivan is the other co-editor. And we do have some other authors who are contributing or who have contributed to the book. And you can find that book. I mean it's just Google yoga and science in pain care, treating the person in pain. It's on Amazon, Barnes, Nobles, you know where books are sold.
Karen Litzy: 35:25 I can say I have not read all the chapters, but I have read several of them and I 100% recommend this for healthcare practitioners or not even healthcare practitioners. Really anyone. Because I just find that for me, it's helping me to kind of look inward a little bit more what I'm doing and not doing and what I can improve upon. And a lot of good reminders of pain science and, and things that I can thentalk about with my patients. I think in a way that, that they're understanding and integrating yoga and integrating compassion, integrating breathing and things like that into my treatment. So I'm finding it very helpful from a practice point.
Shelly Prosko: 36:22 Exactly. That's great. Yeah. That was our hope. You know, our hope was that healthcare providers, regardless if they wanted to go deep into, you know, the yoga therapy and bring yoga into their practice or not, you know, we wanted this to be helpful for, you know, people who, you know, just might be informed by some of these teachings. And of course informed by the science and in mind with what the contemporary science is telling us around patients.
Karen Litzy: 37:05 Yeah, exactly. And it's also nice because it's not like, it's not super heavy. It's not like you're like, Ooh, boy, like I need five hours to read two pages. You know what I mean? Cause it's written in simple language, which is very nice versus so you're taking all these studies that are very scientific and able to simplify them and distill it down into something that's very easy to read. And I think that's why it sticks. So well done for you guys on that. You can find the book at any bookseller and we will have links to it on our website. And Shelly, thank you so much for coming on. I mean this is great and hopefully it allows people to at least look into compassion training, at least start incorporating this with clients and with your patients. So thank you so much for coming on. I appreciate it.
Shelly Prosko: 38:02 Thank you. Thanks so much for having me. I'm just so, so, so grateful.
Karen Litzy: 38:06 Yeah. Pleasure, pleasure. And everyone, thanks so much for listening. Have a great couple of days and stay healthy, wealthy, and smart.
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