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 remember hearing from others 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:

The support worker, Maeve, brings Toni to my practice. 

Toni and I have a discussion about paranoid schitzophrenia. She 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.

According to the Feldenkrais Method, a practitioner creates the ideal learning environment, a place where the person can be safe, and to me, that is a place where there are no absolutes, where Toni's knowledge of her self is heard, acknowledged and understood.

We pause in the conversation, upon the treating psychiatrist’s "zero tolerance" for voices of any kind, and have a laugh about it.

Toni is sore. She has arthritis. Her knees are sore. I find much nervous system activity in the head (thinking), and little weight in the feet (sensation and movement, in this case). 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 her diaphragm and breathing, which are given the opportunity to let go, stop their habituated holding, and 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.

Toni has the opportunity in a session to be the authority on how she experiences life with a degree of voices, and how she experiences herself with a degree of medication. She has found the best balance - for her - of both. I and my work support this.