Ellen Helga Weiland, LCSW

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. [Gilbert Rouget]

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.]

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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 aggressive.

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 about him.

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 his hospitalizations.

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.

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"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 integration.

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.

I explained when he randomly, and simultaneously talked from all of these places, I could not make sense out of his content. I asked that he stand near the black board to talk, that he decide from where he would talk, point to that place, and say what he wanted to say. My hope was that this focusing aid would improve his mindfulness in speaking.

After my brief demonstration, and some fumbling on his part, he was able to use this concept to express himself more clearly.

Using the black board, touching the circle for emotion, he slowly told the group, "I am afraid. There is someone on this unit now, whom I have never met, but whom I have always known." He touched the spirit circle, and said, "I knew him in a place of violence. Our souls were not in these bodies. There was much violence." Paul looked at me pleadingly.

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I guessed he wanted to connect. I asked him if that was true. He agreed, and stated, again using the black board to organize, "My family does not allow it."

The tension was high in the room. Every client's undivided attention focused on the connection evolving between Paul and myself. I will not easily forget the power of this group's holding pattern.

There is something about a moment of truth that usually makes the most dysfunctional person stand by in full support and attention. This was such a moment.

Having worked with clients labled schizophrenic, whose language is often less than useful or conprehensible, I have learned to sense the most subtle changes in their consciousness. I have even developed some psychic skills, and an ability to see a wider than customary range of the energy spectrum. [Jack Schwarz]

Here, now, I felt a strong pull on my second chakra, below my navel. Having worked so long to effect any connection with this client, I felt a tremor of concern about whether I could manage the intensity of it. In the hope of dissipating some of the energy, I asked Paul to sit in his chair, and to continue his work from there. He agreed. I thought, at the time, that he understood the magnitude of his intensity, and its possible effect on me. He confirmed that for me subsequently.

We seemed to be connected by a chord, gut to gut. Between us, there ensued a non-verbal information exchange, as I felt the heat in my abdomen rise. I was conscious of the thought "I am the pain of a thousand, thousand souls." I experienced still a further increase in energy, and suddenly saw a red flaming ball of fire leave Paul, travel across the chord and move towards me. I recall thinking that time was moving quite slowly, as this ball of fire neared me.

For a moment I wondered what I had gotten myself into, but felt compelled to honor my invitation for Paul to connect. I could not abandon him as he was finally accepting it. The red ball of fire jolted me as it moved into my abdomen. I hurt. I felt abdominal pain.

We were locked into each other through sight, sound and kinesthetics while the remainder of the group participants stared in utter silence. Paul watched me intently as he explained, "That pain was mine a long, long time." Never having consciously experienced such a painful energy exchange before, I found myself wanting both to respond to Paul, as well as to validate my own experience.

I asked him how he knew I was in pain. He said "I know", as he gave me a knowing, empathic look. I validated his perception, reassured him I was all right and cleared out the energy as best I could at that moment. He reached for me and asked for a hug.

Paul no longer needed the black board. The next day and every day thereafter, while he was with us, he was cognitively clear. His language was no longer a problem. His ability to get closer to staff and peers was improved. He was discharged within seven days.

Needless to say I was asked many questions as to what prompted his sudden improvement, few of which I could answer scientifically.

When last I heard of him, several years after our experience on the unit, Paul was residing in a transitional living center and holding a part-time job. I have had no follow up information about him since that time.