“There haven’t been any tears of despair for a long time.”
Julie decided to try out the Feldenkrais Method on the recommendation of an acquaintance who had been greatly helped to get back to a normal life after several of her vertebrae had been surgically fused. This delightful mother of two now in her mid-forties was very shy and also a little frightened when she came for her first Functional Integration lesson. I learned that two and a half years previously Julie had suffered a stroke in hospital following a brain haemorrhage. This had left her left side paralyzed and completely helpless during five months in hospital; subsequently she needed constant assistance at home. Since that time Julie had slowly regained the use of her left hand, learned to walk with help, and to use her eyes in such a way that she could overcome the reduction of her field of vision on the left. However Julie’s entire left side – especially the left foot and leg - continued to go into painful spasms.
What was most unsettling to Julie was that both doctors and physiotherapists focused virtually exclusively on getting her to put the left heel onto the floor and shift the weight over to the left side.
As the leg and foot kept stubbornly refusing to obey her good intentions, she began to feel more and more distressed, inadequate, and finally deeply depressed. According to her husband, Julie’s irregular and shallow breathing sometimes seemed to stop altogether during the night. Even more worrying were occasional seizures causing rapid and completely uncontrollable eye and head movements to the left. The last of those “fits” happened at the end of a holiday abroad shortly before our second FI session. As on previous occasions the uncontrollable head jerking could only be stopped by a very strong dose of medication. It may be pure coincidence but since that time, three and a half years ago, there has not been another occurrence of such frightening attacks.
She kept apologising for being “a bad and stupid patient”.
What became apparent to me during our second encounter was the need to prepare the ground for the development of mutual trust because many negative and often painful previous “rehabilitation” experiences had left Julie hopelessly stranded in a double bind. On the one hand she obviously knew deep down what she might be able to achieve; on the other she kept apologising for being “a bad and stupid patient”. Such expressions of lack of self-esteem tended to accompany what she called an uncontrollable “squirming” of the affected leg and foot (all sorts of weird spasms and holding-patterns) as we were beginning to listen to what Julie’s nervous system was signalling. We found that such dysfunctional patterns were automatically set in motion whenever she directed attention to the parts of herself which were beyond her control.
Eventually we found a rather strange way of dealing with the problem. We made a solemn contract:
Julie would immediately replace every automatically uttered doleful or apologetic “Sorry!” with a cheerful rather unladylike “Sod it!”. We found to our surprise and delight that we had actually hit on an effective strategy for gradually neutralising the “useless patient” role Julie had become so accustomed to in all her physiotherapy sessions. After a few lessons we had become travelling companions on a journey of learning and discovery.
The first and most important finding was the undeniable fact that anxiously focusing on problems is completely counterproductive.
Another major discovery involved the surprisingly beneficial effect of being supported by inflated physio-balls forming an “air table”. (See Feldenkrais on Air: A powerful means of communicating with the human nervous system) Fierce spastic contractions, especially in the area of her left shoulder, caused Julie constant pain. Lying on the back had become completely impossible for her because that position aggravated her suffering. However the responsive surface of the air-table, which I occasionally use as an alternative to the much harder regular couch, allowed Julie to lie on her back again. Her torso stopped being a rigid block virtually immediately and small undulations began to appeare here and there – especially in the back.
Julie experienced this loosening as a tremendous relief. For a long time though she could only get on and off the somewhat wobbly contraption with the help of her husband and myself. But every time she lay on it, pain and spasticity would melt away, and Julie began to sense more and more clearly that her body had the capacity of reintegrating into a more harmoniously functioning whole.
Eventually Julie felt secure and agile enough to lie down and get up without her husband’s help; and later she didn’t even need my help for turning around on the gently swaying air table.
As the months passed it became clear that Julie began to experience fresh hope and confidence that she would get back to walking.
What she appreciated most of all about the Feldenkrais approach was that there is absolutely no pressure to “perform”. Julie was sure that as a result: “There haven’t been any tears of despair for a long time”.
Her husband began to observe that his wife’s breathing was improving thanks to the overall reduction of stress and worry.
Despite continuing frustrations, Julie kept making progress. She began to sense that she could suddenly do things which once seemed impossible, such as lying on her stomach and lifting her left leg a little. As her entire body came out of the kind of imprisoning “box” Penny talked about (See What my Body had been Waiting For”), Julie started developing more and more skill in shifting her weight onto the entire sole of her left foot in walking. As a result she no longer felt the need to look down to the ground while firmly gripping the hands of the person assisting her. Sometimes simple palm to palm contact was enough to give Julie sufficient security – and trust in herself.
Eventually we could increase the intervals between sessions to one every three or four weeks. Julie is continuing to progress - with the help of a number of air balls she found most useful and the active support from her husband who has come to understand the Feldenkrais Method because he kept learning together with his wife.
Neuro-Rehabilitation: top priority - neutralizing a negative self-image