Proposed by a Hungarian positive psychologist named Mihály Csíkszentmihályi, flow is the mental state of operation in which a person performing an activity is ‘fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity’.

I am almost certain that if I couldn’t get into a state of flow while performing patient care, I wouldn’t be a physical therapist. Its also one of the reasons why I enjoy being engaged in a busy clinical setting, with just enough patients to where I can flow from one to the next with just enough time to get mandatory documentation and such accomplished.

This is so much more enjoyable than a slow day that drags on and on, or a day that is so hectic that I can never catch up. When I get just the right amount of patients scheduled and making great progress on their goals, time seems to disappear. I’m in control and the day feels like a dance put together by a master choreographer. That is flow.

You have to be involved in an activity with a clear set of goals and visible progress. This adds direction and structure to the task.There are three conditions that flow theory postulates have to be met in order to achieve flow:

1. The task must have clear and immediate feedback. This allows you to adjust performance to maintain the flow state.
2. There must be a balance between opportunity and capacity. In other words, there is opportunity inherent in the task and you have the capacity to meet the challenge of the task.

Clinical practice can often meet all of these requirements when we are fully present and engaged. One of the ways I get into flow during a busy clinic day is by avoiding email, facebook and other distractions. I put my electronic medical record system in full screen mode and avoid the temptation to ‘check in’. This by itself doesn’t create flow state, but one thing is certain - you can’t flow while you are distracted.

Patient care lends itself to meeting the requirements for flow. We often see changes and make improvements immediately when working with patients. This gives us not only goals and visible progress, but immediate feedback.

We have the opportunity to make large improvements in patient’s lives, and we definitely have the capacity to make those changes. Few clinicians have the same opportunity to make immediate improvements and gain the reward of instant positive feedback. This is part of what makes physical therapy a highly sought after profession.