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Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.


Wednesday, May 7, 2014

How to Sit




In the introduction to his book, How To See, George Nelson remarks that he should have more properly called the book, "How I See". With that in mind, I should have probably entitled this post, "How I Think I Ought to Sit."

But I need to digress here to include this anecdote about the Nelson Ball Clock:

George Nelson recalls the iconic design of the Ball Clock as being a result of a night of drinking with friends and associates, Isamu Noguchi, Bucky Fuller, and Irving Harper.

“And there was one night when the ball clock got developed, which was one of the really funny evenings. Noguchi came by, and Bucky Fuller came by. I’d been seeing a lot of Bucky those days, and here was Irving and here was I, and Noguchi, who can’t keep his hands off anything, you know- it is a marvelous, itchy thing he’s got- he saw we were working on clocks and he started making doodles. Then Bucky sort of brushed Isamu aside. He said, “This is a good way to do a clock,” and he made some utterly absurd thing. Everybody was taking a crack at this,…pushing each other aside and making scribbles.

At some point we left- we were suddenly all tired, and we’d had a little bit too much to drink- and the next morning I came back, and here was this roll (of drafting paper), and Irving and I looked at it, and somewhere in this roll there was a ball clock. I don’t know to this day who cooked it up. I know it wasn’t me. It might have been Irving, but he didn’t think so…(we) both guessed that Isamu had probably done it because (he) has a genius for doing two stupid things and making something extraordinary…out of the combination….(or) it could have been an additive thing, but, anyway, we never knew.”


End of anecdote.

I while back, I wrote a post, Chairs, in which I described some chairs I like, and the problems I have with finding the right chair. I've been working diligently on this problem, by trying out different chairs, but in order to find the right chair, I needed to figure out how to sit.

Ergonomic desk chairs lean back-the proper angle is supposedly 100-110 degrees. And they assume the presence of a desk, so you can lean your forearms on said desk. What I've discovered, and I'm speaking only for myself here, is that leaning back is terrible for my back. Another bad thing for my back? Leaning forward. 

If I stay in either position for too long, I'm asking too much of my paraspinals.

What to do? The obvious answer is, sit straight up. This isn't so easy, and most chairs don't facilitate it. And it's not just sitting straight. I find that in order to keep my lower back (iliocostals, specifically) from going into spasm, I need to sit with my shoulders down and relaxed, and my abs pulled in. 

A recent article in the Washington Post concurs:




This is difficult enough to accomplish with desk work. When I'm facing a patient, trying to listen intently, I tend to lean forward. When I'm sitting behind a patient on the couch, trying to let my mind associate freely in response to the patient's associations, I tend to lean back. 

And I'm fidgety, in general, so I tend to be all over the place. Sitting has become an occupational hazard for me, and I need help. Surprisingly, desk chairs are not that helpful. 

Take a look:


Think Chair
This is the Think Chair by Steelcase. It looks pretty upright, no? But it's springy. As soon as you sit down, it'll lean back, unless you try to lean forward to type at your computer. But that's not what I do when I'm with patients.

The same is true for the Aeron Chair:


Aeron Chair
The lower back support is good, but see how the upper section leans back?

I went to Design Within Reach a few months ago, to try to sit on as many chairs as I could, and see if anything worked. I tried every likely-looking chair in the place, to no avail. I was ready to give up and leave, but I was tired, and it was hot out, and the woman who was working there offered my a bottle of water. So I took it and just for fun, sat down on a chair that I love the look of, but that I always thought would feel torturous to sit in. It's the Cherner Armchair.


Cherner Armchair

Those of you who watch Dexter and pay attention to furniture, like I do, may have noticed that our hero, Dexter Morgan, has this chair in his living room. Appropriate for a fastidious serial killer.

Guess what! It's not springy, and it doesn't lean back! 



And there's something about the way the seat is carved that keeps you from sliding down. Also, even though the arms look awkward, they actually put YOUR arms in a naturally relaxed position. 

Did I buy it? No. In addition to a chair that could save my back, I was looking for a chair with wheels and adjustable height. A task chair. But wait! The Cherner Chair Company MAKES a task chair:




Did I buy it? No. I was a little concerned because the arms aren't curved downward in the same way as the armchair. At least they don't appear to be. I emailed the Cherner Chair Company about this (I'm in earnest about this chair business), and they said that the arms are exactly the same height as those on the armchair. And the real problem is, Design Within Reach doesn't have the task chair in the showroom. So I couldn't do a comparison. 

And these chairs cost the kind of money that I'm willing to invest in if it means I won't be in pain most of the time, but without that guarantee, I'm reluctant to plunk down that kind of change.

In any case, it's impossible to tell from sitting in a chair for a few minutes in a showroom what it's like to sit in that chair all day. 

So I'm still in chair limbo.

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