In the early 80's I worked as staff at the
adult intensive treatment unit of a private psychiatric hospital. I was
then, and am still practicing as a Clinical Social Worker, though the
needs of my clients, and my interests moved me to include shamanic
practices along with my more traditional treatment interventions.
My interests then as now are oriented
towards the varied states of consciousness. I want to know what prompts
spontaneous shifts of consciousness. I am particularly curious about
those inflexible regressive states which appear to trap clients in
malfunctioning childlike, or nonproductive, uncreative persona.
I am exploring the relationship between
symbolic thought and literal thought. I want to discover whether and
how consciousness is divided between body and mind, and what role
thought plays in that division. How do thoughts translate into body
action? Why does verbal interventions so often fail to promote long
term change with a large percent of clients; Why is "knowing what is to
be done" so distant from "the doing."
My fascination and exploration within the
realm of anthropology and the study of tribal behavior suggests that
many of the "disabling" states of consciousness, which I have seen in
the hospital, were/are considered normal in tribal cultures, and are
dealt with in ritual, often sacred gatherings.
In other words, many cultures allow a time
and place for people to experience consciousness shifts with community
sanction, and set the expectation that, after the ritual , people move
back into a state of consciousness more appropriate for daily activity.
I was fascinated by the fact that mental
illness, in such cultures, was noticeably less diagnosed as such than
in our culture. I thought I could learn to incorporate such wisdom into
my practice. [Mircea Eliad]
My clinical experiences, using traditional
verbal interventions, suggested that encouraging clients to talk about
their problem again and again, perfected their reporting function but
did little to change the behaviors traceable to the trauma. I came to
believe that as an agent of mental health, my continued willingness to
listen to such reporting served to entertain the problem rather than
alleviate it. It appeared to be counterproductive to my professional
commitment and with some exception, not in the service of the clients'
coming to balance.
I found prolonged discussion of crisis
particularly counterproductive with abuse survivors, who had little
difficulty in repetitive reporting or abreacting, once their abuse was
no longer a secret. They seemed to be addicted to pain, and had their
addiction nourished by my agreeing to listen to their repetitive
reports. I was not interested in feeding addictions.
I searched for ways to free the
body/mind/spirit system of the tyranny of past trauma lodged in the
unconscious. I usually asked the client what they thought they needed
in order to come to health and was often surprised at their ingenious,
creative and workable solutions.
I invited clients to recreate their history
in a healthy, symbolic drama which frequently prompted a cathartic
crisis resulting in change. It seemed that the cathartic re-experience
rather than the intellectual recounting made the difference.
Suffice it to say that I was interested in
learning what kind of staged drama, or ritual, had what kind of effect
under which circumstances, and what went on in the body/mind/spirit
system that allowed such transformation. The extent of my findings are
fascinating and the subject of upcoming works. In this essay I am
concerned with one particular case. [The name has been altered to
protect the identity of the client.]
Our hospital population, at the time in
question, consisted of the acutely mentally and emotionally ill, often
those with a record of frequent recidivism. Many of our clients indeed
lived a productive life between their psychiatric crises.
Not so with Paul. Paul was thirty-seven
years old. He had a career in the army until his first "psychotic
break," fifteen years before I met him. Paul's family was well to do.
He had a sizable estate of his own, consisting of money from the
family, and proceeds from a law suit surrounding a mysterious event
which supposedly led to his condition. No information was ever
available about that mysterious event.
Paul had spent the last fifteen years being
moved from one psychiatric hospital to another. Records showed a
history of his having been confined to several state hospitals,
numerous private ones, as well as some Veterans institutions. For
fifteen years, Paul had seen the limited world of psychiatric
institutions mainly through, what I call, his "psychotic" lenses.
I had worked with him on three different
occasions when he was hospitalized on my unit. His jumbled language
seemed in direct proportion to his emotional closeness with staff and
peers. If his language did not create sufficient distance, he became
On rare occasions he made what seemed a
desperate attempt to communicate some-thing of importance. His language
content then, was for the greater part, incomprehensible.
Paul was a beautiful human being and a
tragedy all at once. His compassion, especially towards female peers in
trouble was noteworthy. I, as well as many staff grew to care deeply
Paul and I had reached an understanding. We
agreed that I would continue to care for and about him as a fellow
human and friend, but that I would give him the space he wanted until
he was ready to connect in relationship. I informed him he did not need
to scramble his language intentionally to keep me at a distance. He
smiled and agreed silently. And so we worked our way through several of
During our third encounter, in a two years
time span, and in greater than the usual confusion, he remembered, and
maintained our agreement. Paul reluctantly participated in our monthly,
day long marathons.
Marathons were a ritual time which I used
to build community, reaffirm and empower health and personal strength,
as well as to introduce new ideas, skills, fun activities, and
celebration which would encourage clients to release old life patterns
and draft new ones. It also encouraged staff to see client in a new
light. It was a time of equality between everyone on the unit, which
often encouraged staff into transformation as well. I especially used
marathon occasions to lighten up the intensity of this normally grief
ridden unit, and to evoke transformation, by what a teacher of mine [Robert E. Masters] called the
"seduction of consciousness by novelty," that is by engaging the
body/mind/spirit in movements it is unaccustomed to making.
Marathon time occurred on a locked
psychiatric unit which housed 14 clients. A glass partition separated
them from the nursing staff, who normally used a key to unlock the door
in order to cross into the patient area. They were as
physically/emotionally locked in as we were locked out.
The perimeter of the unit was lined with
private rooms, each with a window with protective screen. The unit had
a day room and a group room, as well as several meeting rooms reserved
for doctors. In the center of the unit was a large area which housed
benches and several planters devoid of any plants because clients had
tried to make a meal of them. The unit was newly built with pleasant
colors and modern oak furniture.
Marathon time consisted of one eight-hour
day. On occasion the staff became so involved and excited by the goings
on that we planned the subsequent event to last a full twelve hours.
The staff usually included one or two
nurses and an activity therapist. Not all of them were on unit at the
same time. Frequently I was alone or with one other staff member. In
the event a client participant was deemed to be unpredictable, or
dangerous to self or other, I insisted on the constant presence of one
staff member in addition to myself.
I must say that in my many years practice,
clients were often very sick, and disruptive upon arrival in the
hospital, but rarely acted out during marathons or any of my groups.
The worst that happened was that they would not leave their room to
participate. Strange as it was, even very difficult clients looked
forward to these rituals. It was an unspoken rule that clients did not
make waves on Marathon days.
The time was structured to include a community meeting, several meals,
and a variety of activities which generally included psychophysical
exercises, bio-energetic work, arts and crafts, psychodrama, sacred
dance, an eclectic group therapy which included guided imagery, altered
states work, and occasionally regressive experiences.
I did not structure a rigid division of
activities. Each was blended into the other art, movement, music,
drama, psychophysical exercises, imagery, meals festively planned to
suit a chosen theme, all interacted to encourage an awakening and
discovery of the self. The day culminated in a celebration of the self
and the community which allowed the safety for such a journey.
Lunch with the hospital offering festive
foods rest period group therapy [to process and deepen the mornings
work, to explore and integrate aspects of the self, and to find support
and validation for new patterns] Afternoon activity encouraged clients
to spend excess energies, and assure a calm evening and night.
A celebration organized by the clients with
staff assistance, for staff , clients and family, ended the evening.
Throughout the day I played various types
of music from around the world, new-age, Australian aboriginal, well
know classical pieces, jazz, Peruvian folk melodies. Native American
chanting or flute music, drumming whatever I thought would help me to
orchestrate the energies. My intuitive sense that music serves to
change the mood of the listener, supported by musician/writer such as Don Campbell and Joscelyn Godwin keeps me forever on
the alert to add to my collection of new and ancient works.
The participants of this particular
marathon included fourteen fairly troubled adults as well as staff. I
planned to introduce experientially, for the first time in the hospital
and on this unit, the concept of the kinesthetic body.
"The 'kinesthetic body' or body image"
according to Jean Houston "is
the body of the muscular imagination. Each of us registers directly in
the cells of the brain a representation of our body. This
representation was charted by the neurosurgeon Wilder Penfield, and it
illustrates quite graphically that the neurological awareness of
different parts of the body is not proportional to the actual sizes of
the parts but is instead related to their use in manipulating and
interpreting our external environment."
It is my finding, supported by the many
self images drawn by the clients, that within the psychiatric
population this kinesthetic body is usually more or less disturbed. The
use of psychophysical exercises
facili-tates the transformation and organization of the image body.
When I saw the severity of our populations' dysfunctions, I questioned
my own wisdom in presenting this exercise. I fell victim to my own
belief system which suggested these clients did not have enough
capacity to process such work.
I firmly believe that our functioning in
the world is dependent upon how accurately we sense ourselves; yet I
also know that people, and particularly dysfunctional people often have
a tenacious resistance to change, especially sudden change. There was a
small chance that one or more of the group members might loose control,
or "de-compensate", rather than gain quality self awareness and
improved functioning. After talking with staff, we all agreed this
populations could hardly become less functional, and that in most
instances a de-compensation could be considered progress. Having
nothing to loose, I forged ahead with my plan.
Paul remained in his room, declining my
invitation to participate. I offered him the option to change his mind
later. We began the exercise. I played some well-known march music by
Sousa, as I led the exercise. Everyone was jumping and lurching,
imaging themselves in a fencing match in resonse to my directions . One
moment the clients were moving with their physical body, the next
moment they were holding their physical body still, while they imaged
moving their kinesthetic body. Then they integrated the movements of
their kinesthetic body with their physical body, consequently "coming
home" to themselves. Not one person had any difficulty following
instructions, unlike during their usual daily activities. I saw intense
looks in their faces as they alternated between the prescribed
movements, and then shared their experience and advance towards
I had seen Paul in his doorway.
Unobtrusively he joined the action. After a few moments, I changed the
music to a waltz. He and the others moved with their eyes closed, in
seeming ecstasy. Paul followed the guided movements with tears
streaming down his face.
I directed the group to pair off and mirror
dance with one another, and then, finally to mirror dance with their
own kinesthetic body. Paul complied.
The exercise ended with Paul continuing to
sway to a music of his own. The thirteen other clients sat in calm,
self satisfied wonderment. Paul just muttered "I have not been alive
like that in fifteen years. Don't let it stop." More than one staff
wept tears of joy at the sight of this tenacious psychosis yielding way
to a moment of pleasure and seeming self unification.
In group therapy, following the day of the
marathon, Paul tried painfully to tell me something. He failed
miserably and visibly showed his frustration in change of skin color
and facial tension. I acknowledged his upset and suggested he allow me
to give him a structure to communicate his ideas. He looked baffled.
I had noticed that his use of words was not
as random as I thought. It seemed as though there were several people
speaking at once, each talking about a different topic, and none
waiting his/her turn. The result was an incomprehensible confusion.
I offered him a black board with four
concentric circles calling into play the distinction of spirit, mental,
emotional, and physical planes; I raised the distinction of "me"
"Not-me"; I also offered him a time line representing a continuum of
past, present and future.