Thursday 28 January 2021

Working with schizophrenia: a balancing act

Hi to all. It’s a new year’s resolution to write blog posts! I hadn’t quite stuck to the schedule. Hadn't yet found a topic for inspiration. Then a client walked in and, with her, inspiration arrived. 

Toni (not her real name) has been diagnosed with paranoid schizophrenia. 

Toni has undergone shock treatment, and has been prescribed high doses of medications, including those commonly prescribed for bipolar disorder. I understand that these medications can be helpful, and they can tip you over into being so subdued, you lose your lust for life.

Our interaction went like this, and this story is told with consent:

Toni arrives. We take a seat in my loungeroom, and we have a discussion about paranoid schitzophrenia. Toni jokes about how the voices have come back, moderately, due to a slight reduction in her medication, and she is happy with that. 

She is also happy to be on a reduced dose of medication, so that she doesn't experience the full extent of the medication's side-effects. For her, this means being able to go out of her apartment more, engage with the world more, and this helps with her anxiety, and with the voices! The whole thing is a balancing act.

A practitioner can create the ideal learning environment, a place where a person can feel safe. To me, that means Toni's long-held knowledge of herself and of her condition needs to be heard, acknowledged and understood. We pause in the conversation, upon the treating psychiatrist’s "zero tolerance" for voices of any kind, and have a giggle.

Toni is sore. She has arthritis. Her knees are sore. I find much nervous system activity in the head (indicating activity including thinking). There is little weight in the feet. We bring Toni's attention from the activity of her head though movement, to throughout her body and all the way to her feet. 

We get there via the movement of her diaphragm and breathing, which are given the opportunity to just be, cease their habituated holding. For a while she feels far less anxiety, and her mind is quietened.

During the session, I ask Toni if she has a busy mind, something I encounter with most everyone who comes to my practice (me included, except when doing Feldenkrais 😉). She says she does. 

I believe there doesn’t have to be a wide schism between the way we think about paranoid schizophrenia, and the way we think about the whole spectrum of voices, self-talk, attitude, beliefs.

For Toni, in this session, normalising her experience of herself is part of the process, a way of understanding herself without the obstacles of shame and judgement. 

In short, we succeed in increasing Toni's base of support through gravity, bringing weight and holding from the head and shoulders down to the feet, reducing musculoskeletal tension, hence reducing her chronic pain, and ultimately, expanding her ability to sense her whole self - sensations, movement, feelings and thoughts. Expanding her capacity to shift herself in various directions, to have a sense of options.