Auntie Version - MSKMag's Agony Aunt - June 2025

Hello! I’m Auntie Version (aka Jo Turner) and I am unbelievably excited to be MSKMag’s very own agony aunt.

Oh the arrogance in my assumption that I have any wisdom to impart about your life, and the irony that much of my advice will implore you to resist that clinician’s urge to fix and advise! Nevertheless, I do hope you’ll find this column informative, thought-provoking, occasionally amusing and that you’ll find some helpful tips amongst my best guesses and opinions.

Dear Auntie Version,

I have been both a mentor and a mentee and understand when it can go disastrously wrong and the lasting impact that can have... This may be as simple as a difference in personalities or misunderstanding/lack of effective communication between one another. This can cause toxicity in the working environment, particularly if several colleagues experience this with the same mentor. What makes it more difficult is when mentors are in high positions of authority. 

What advice would you give a mentee who is struggling with a toxic mentor in high authority/ a toxic work environment, which is not changing? 

What advice would you give a mentor who is struggling to build rapport with a mentee? What advice would you give a mentor in relation to how they can grow from difficult mentee/mentor relationships?

Yours, 

Perplexed

Dear Perplexed,

My first thought would be to make a distinction between mentorship and appraisal. Mentorship should be a voluntary process whereby you recognise a gap in your knowledge and seek guidance from someone with relevant experience. As opposed to appraisal which might be an obligatory part of your employment contract, and where you have no choice over your appraiser. 

If you’re in a mentorship situation and it turns toxic, whether due to personality clashes, communication breakdowns, or even poor behaviour from the mentor, it’s perfectly reasonable for you to request a change. You shouldn’t feel trapped. Everyone deserves a mentor who is right for them and wants the best for them.

To build rapport, it’s crucial to understand why the mentee has sought your help. What are their goals? Where would they like to be as a result of working with you? They likely see something in your experience or career that they want to learn from. But mentorship isn’t about them replicating your exact path; you should help them interpret your experience to fit their circumstances. 

I think it’s helpful to be open about both your successes and your failures. Share what worked for you but also acknowledge what you would do differently today. This vulnerability could go a long way in building trust and rapport.

Growth in any mentorship relationship requires self-reflection and humility. A mentor could ask themselves, “What was my part in this?” It’s easy to focus on the other person; harder but important to ask what could have been done differently on your side.

It might also be helpful for a mentor to seek mentorship themselves. They would then better understand what good and bad feels like for them and be able to adapt their approach.

Dear Auntie Version,

When I set up my private practice, I always used to imagine I'd be able to offer free advice/treatment to my family and friends...but as much as I'd like to do this, I still can't afford to. When friends come to me for advice and I tell them to book in, I can't help but feel I should be following it up with "and of course, it's on the house!" How can I get around my own awkwardness in charging the people dear to me for my clinic time?!

Yours, 

Awkward

Dear Awkward,

I think I’m hearing a belief that your family and friends expect free advice and treatment. 

Do you know this to be true? 

What else might they be thinking?

We know that personal recommendation is one of the main reasons people decide to go with a particular therapist. Could it be that they feel very comfortable asking for your help because they know and like you and they know you have a wonderful reputation?

What if the shoe is on the other foot? Do you seek financial or legal advice from your lawyer and accountant friends and presume it is going to be free? Do you feel affronted when they charge you? Or do you feel a bit awkward if they don’t? 

Your answers will be an indication of your own personal value and boundaries.

This question is a close relative of, “How can I put my prices up?” Of course, there is awkwardness the first time you say the new price, or the first time you invoice your best mate. But isn’t there also a gnawing, unpleasant feeling every time you don’t? And the second time you say the awkward thing, it’s never as bad…and every time after that it gets easier. 

Next time the situation arises, why not challenge yourself to do the hard thing; Resist giving away your skills and time for free. 

Ask yourself afterwards…

• Do I feel guilty?

• Did I do anything wrong?

• Can I do it again?

The more you confront the discomfort, the more confident you'll become in setting and respecting your own boundaries.

Dear Auntie Version,

I keep reading posts and articles about the poor state of physiotherapy. How there is lots of poor, unregulated, non-evidence-based practice going on. I am always wondering if I’m getting it right for my patient, worrying that other people know much more than me. I have this constant feeling of waiting to be found out. I know these articles are well-meant and the intention is to raise standards. But reading them just makes me feel more anxious and inadequate.

Yours, 

Feeling Inadequate

Dear Feeling Inadequate,

I know you won’t be alone. These concerns come up a lot when I am coaching clinicians. I think there are a few reasons for this.

We know from an increasing body of evidence that perfectionism is a common trait amongst those who go into Physiotherapy and, I suspect, other MSK disciplines. Imposter syndrome is also highest in professions where technical ability is highly valued, such as in healthcare.

Brene Brown describes perfectionism (the pursuit of unattainable goals) as a defence against shame and vulnerability. She contrasts it with the more positive trait of healthy striving - working towards challenging but realistic goals to steadily move forward.

When we read articles about raising standards or stricter regulation, it’s easy to feel like any criticism must be directed at us. And rather than hearing a call to reflect and consider reasonable actions for improvement, it might sound like there is an impossibly high bar that of course we won’t be able to jump. That we’ll never be good enough, or worse, that we don’t belong. And our action might be to shrink. This is the perfectionist mindset.

There might be another, very different reaction. On hearing criticism we might become defensive, refusing to accept any feedback, and stubbornly sticking to our path. 

I wonder whether both reactions might actually stem from the same core fear: not feeling good enough. If that's the case, then perhaps the antidote lies in compassion, toward ourselves and others. That means cultivating an internal voice that offers a more balanced perspective on our abilities and achievements, one that recognises both successes and struggles in the context of our current circumstances and available resources.

Changing years of harsh self-talk isn’t easy, and it may take time and support. Speaking with colleagues might help you challenge the belief that you're the only one feeling this way.

To the authors of those posts and articles: I wholeheartedly support efforts to raise the standards of our profession so we’re better valued, funded, and respected. But it’s worth remembering that many clinicians reading these pieces are already deeply committed and conscientious. Sometimes, the language used can inadvertently reinforce perfectionism or imposter syndrome, leaving readers feeling like they’re not measuring up.

Perhaps what we need is a little less stick, and a little more carrot.