Road to realization
The mis-match between the writing and wright hand as co-factor in a variety of conditions still doesn’t figure:
• in the professional training of teachers, psychologists, psychiatrists, physiotherapists, speech therapists etc.
• in the (American) DSM or (UK) list of admissable diagnosable conditions.
• in textbooks or popular books on ‘mental health’ or ‘neuro-diversity’
This has not prevented the condition being acknowledged in expert testimony reports. Perversely the British Psychological Society has:
• rejected its role as a co-factor in a variety of presenting problems
• rejected the opportunity to mount a workshop to educate other psychologists.
• has considered it to be acting outwith professional standards to consider its role in a variety of presenting problems.
This raises the question of how I came to realize the significance of the MBM mis-match. The following account attempts to re-trace this path.
1: Reflective practice
The answer to Professor McKay’s question is that I had been moving across the BPsS’s ‘specialist’ fields (silos or blinkered rituals). Indeed the very structure of the BPsS, where psychology as a discipline is fragmented into different specialisms, or as Gillian Tett would call them ‘silos’ militates against the discovery of the condition since the discovery involved ‘crossing’ different specialisms.
The more complex answer is that I was heavily influenced by the work of two philosophers in particular: Karl Popper and Stephen Pepper. Karl Popper drew a distinction between problem-driven and discipline-based thinking. He made the further claim that there are no such things as theory-free observations. And this is so for the very simple reason, how does one know what to look for unless one has a view of what to look for? The more general problem – called the bootstrapping problem- is, how does someone come to understand something they initially fail to understand? Hence the vicious circle, for to understand something one needs the mental structures to do so, but what if they’re not there? Stephen Pepper’s work on world-views: a study in evidence” was a further seminal influence. He argued that all thinking could be encapsulated in one of six root metaphors, two of which were grossly inadequate as explanatory world-view and four of which were adequate. Although he never explicitly claimed primacy for any of the four adequate world-views it struck me that there must be one which allowed him to ‘step outside’ the others to be able to describe them all. Indeed by playing around with pen on paper it became clear that by deleting the ‘con’ from his ‘contextualist’ world view and creating a Venn diagram of the others the ‘textualist’ world-view lay at the centre of the other overlapping world-views.
As an aside an example of the role of metaphor as a thinking tool is to be found in the fact that every difference in the USA between Democrats and Republicans can be traced back to two different moral frameworks based on family metaphors. For Democrats, the moral framework is based on the metaphor of the nurturant parent, which emphasizes empathy, care and protection. For Republicans, the moral framework is based on the metaphor of the strict father, which emphasizes discipline, self-reliance and hierarchical order.
The principal metaphors I used were
1. the iceberg to represent the fact that beneath the surface of every feature or problem lie a myriad of other features or problems
2. the tetrahedral pyramid to better represent the fact that the intellectual, social, emotional and physical aspects of personhood are not separate discrete components, which may or may not interact together . They are merely different facets of personhood, reflecting our focus of interest. One implication of this model is that if one
facet is found to be out-of-kilter then the other facets will also be out of kilter, although not always obviously so.
3. the jigsaw puzzle to represent the predicament of how to know which detailed pieces fit the bigger holistic picture when not all the pieces are visible or facing up and you don’t know what the bigger picture is.
In this reflective practice it meant viewing the various psychological conditions as pieces of a puzzle of which only the tips were visible against the backcloth of everyday experience.
2: Mapping the territory: stepping stones, fingerposts or paths to discovery
When exploring new territory there are no fingerposts, signing the direction to follow, or stepping stones to indicate the path ahead. This is not a new problem. To quote Francis Bacon (1622)
“When in Search of any Nature the Understanding stands suspended, then Instances of the Stepping stone shew the true and inviolable Way in which the Question is to be decided. Those Instances afford great Light, so that the Course of the Investigation will sometimes be terminated by them. Sometimes, indeed, these Instances are found amongst that Evidence already set down.” 1
2:1 Paths to discovery
It is only in hindsight that it’s easy to see where the stepping stones were that led from blissful ignorance to useful knowledge about a body-mind-mismatch being a co-factor in a variety of apparently unrelated conditions. Now that the stones have been laid they can now act as fingerposts for others to follow.
It should have been possible to identify the role of the mismatch between the writing and the wright hand years before I eventually did, because I had already come across some signs but without recognizing their significance. A principal reason for not doing so was that they were treated as anomalies. And because of the prevailing atomistic world-view I registered them as interesting curiosities instead of puzzling over them more deeply.
2:1:1 Upside-down reader
In my second year teaching a top class in a junior school in London I used to ‘listen to pupils reading’ by inviting two at a time up to my desk. The first pupil would be reading and the second standing behind waiting their turn. In this instance I happened to notice that the waiting pupil seemed to be reading the same text but doing so upside down. When it was her turn to read I told her that I was going to make it really difficult for her by turning the book upside down. I was not completely surprised when she did so with effortless ease.
Comment: I failed to realize that ‘brains’ could do almost anything and that perhaps hers worked differently. It did make puzzle though over the emphasis literacy experts placed on decoding the text.
2:1:2 Mirror writing ‘John’
I was a research student at the MRC Speech and Communication Unit in Edinburgh investigating the relationship between cognitive and motor skills using soft sign neurological tests. I was ‘testing’ the children one at a time. They had to write their name at the head of their Draw-a-Man drawing. A six year old pupil wrote his name, written right to left but read left to right as ‘nhoJ’. He did so with his right hand.
Comment: Again this detail was lost in the mass of other details I was collecting at that time. It was only later that I realized he’d written it perfectly correctly were it to be read as though it were Arabic. The significant fact about Arabic script is that it’s written with the right hand but from right to left and read that way too.
2:1:3 Debugging a mirror image problem
The general instruction when conducting Berges & Lezine’s, imitation of hand/arm gestures, is to ask the child / adult “Can you do what I’m doing? Can you copy me?”
Facing each other, one gesture involved me standing and holding my right arm straight out to the right. On this unique occasion one pupil raised her left hand across her body, hence pointing to her right i.e. in the same direction as me but with the ‘wrong’ hand. This was clear evidence of her being at the transition between mirroring and reversing the mirror image, which generally takes place around 8 years old. The norm is for young children to produce the mirror image, that is raising the left hand pointing to the right and for older children to raise their right hand andpoint to their right.
Instead of telling her she had done it wrong I imitated her gesture, then reverted back to my original gesture and asked her whether my arm had crossed my body? When she replied “No” I asked her if she could also do it without crossing her arm in front of her. Without hesitating she turned her whole body round to face in the same direction as me. She did so while ‘unwinding’ her crossed her arm to finish pointing to her left. When I asked her to glance over her shoulder to see if we were now copying each other, she spontaneously dropped her left hand and raised her right hand. I then asked her to hold that position and turn round to face me, which she unerringly succeeded. Furthermore with the next next gesture, left arm out to the left, she copied with the non-mirror image.
2:1:4 I write mirror for myself and non-mirror for others
When lecturing a class of PGCE students I referred to all three incidents as examples of problems with orientation. At the end of the lecture two female students came up to me offering a comment. The principal student told me that when she wrote for others to read she wrote, left to right, with her right hand, but when writing for herself, she wrote faster and better, right to left, with her left hand.
Comment: Again this was simply acknowledged by me as an interesting anomaly / curiosity. But I later discovered that the experience was very similar to that of Chris Seed, a left handed pianist who made a similar comment about playing a left – as opposed to right-handed piano.
4: Irrespective of the presenting problem
It was clear from this point onwards that any evaluation I conducted or counselling I offered should be done with Popper’s scientific falsifiability criterion in mind. I needed to see if I could eliminate writing with the non-adept hand as a co-factor in the presenting problem whether with children or adults and whatever the presenting symptoms. It is important to note, the issue was not whether they wrote with their left hand or their right hand but whether they wrote with their non-adept hand. If it could not be eliminated then it had to be considered as co-factor in the presenting problem. The implication became obvious: failure to consider this condition would mean that any ‘treatment / remedial action / counselling / therapy’ would at best be inadequate and at worst explain why the success rate of so many therapeutic treatments was so low.
4:1Two adept hands?
4:1:1 Robert: By this stage I presented all clients – children and adults- irrespective of the presenting problem, two A4 sheets of paper in landscape orientation with a pen resting at the head of each sheet. I instructed them “Take a pen in each hand ….. and now write your name using both hands at the same time.” I then asked them to write their name with a pen in each hand and at the same time to the instruction.
Almost always this results in two names, each hand writing the same name, sometimes mirrored, sometimes yolked. Writing only one name is exceptional. This is, however, what Robert did. He wrote the ‘R’ with left and the ‘o’ with the right, simultaneously and at speed, then the ‘b’ and the ‘e’ and finally the ‘r’ and the ‘t’. Robert wrote each pair at the same time and at speed ie with effortless ease.
Comment: In normal circumstances one hand can be considered the writing – head manipulating hand and the other the feeling holding- heart hand. The question then becomes what happens when both are head hands; where is the function of the heart hand to be located?
If I hadn’t seen him with my own eyes I wouldn’t have believed it possible to write with each hand holding to the bigger picture (name) while each attended to the detail (letter). It is tempting to think he could have performed this way because he practised and practised and practised: he hadn’t.
When I later tried to do emulate him I found it impossible. Even writing slowly I found my attention switching between both hands.
While the most people are either right or left handed there’s evidently an infinitesimally small proportion who are neither right or left handed: they have two adept hands.
4:1:2 … and knowing how to behave
Craig I wondered whether there were any other children like Robert. I suppose I shouldn’t have been too surprised to discover that the answer was “Yes”! Craig was living with other children in a residential home for ‘children with a multitude of difficulties’. During the course of the workshop we came to the task of writing his name with a pen in each hand simultaneously. Craig did exactly what Robert had done. But, because there were only five rather than six letters to his name writing there
was one significant difference. He wrote ‘C’ with one hand and the ‘r’ with the other, simultaneously and at speed; he did the same with the ‘a’ and the ‘i’. There was no time to ponder how he would complete the task. But the question which will test your grasp of the body-mind mechanism at play is, “How did he write the final ‘g’?” While the majority of people nominate one hand or the other, very few nominate “… with both hands!” which is in fact what Craig did!
To explain this we have to acknowldge that each hemisphere ‘saw’ the need to put something in the final letter space. But instead of pondering / arguing / debating / being confused over which hand to use, both hemispheres completed the task independently but co-operatively !
The stepping stone was the realization that, given the opportunity, having two adept hands, poses no problem when each is given the opportunity to enact itself. The reason why the task is impossible for right or left handers is that one hemispheres interfere with the other: but with the doubly adept each hemisphere can operate without interfering with each other. It should come as no surprise to learn that hitherto Craig resolved most ’emotional-social’ problems with either both hands (fighting) and or both feet (kicking).
There was a further aspect to Craig’s case. While de-briefing the director of the home how Craig wrote his name and what I thought it was telling us about the body-mind links, Craig was brought into the room by his carer, who was seeking the director’s opinion on whether Craig should be allowed to go into town as a Friday treat since he had not been doing what he should have been doing. The director was about to comment when I asked if I could interrupt briefly. The director agreed. I asked Craig to tell me if he knew what he should have been doing. He gave a thorough account. I then asked him to tell me if he knew what he should not have been doing. He gave yet another thorough account. It was quite clear that knowing what he should and shouldn’t be doing was not his problem. It was matching his doing with his knowing!
The following stepping stones were discovered while conducting home-based family workshops for education purposes.
3:1 “Don’t put your legs on the table”
During early phases of this workshop both parents repeatedly told their top class primary school aged child to sit still, stop fidgeting, stop putting his feet on the table and to listen to me.
I asked them, rhetorically, whether they had ever told him to sit still before. Unsurprisingly they said yes. I then suggested that in that case their and his behaviour needed to change. The pedagogic point being that if their intentions weren’t being fulfilled they too needed to change what they were doing.
At the end of the workshop they were asked to comment on any aspect of the session: what they might have learnt, or a concern they had not yet voiced? Unhesitatingly they said that they were very surprised by the fact that normally he gets more agitated as a session goes on. They couldn’t understand how he ceased putting his feet on the table , reduced his fidgeting and engaged with the tasks. This agreed with my observation.
Comment. As I drove home I knew that the conventional label for such initial behaviour = attention deficit hyperactivity disorder (ADHD- wouldn’t cover his change from ADHD to nonADHD status I was searching for a better label. The image / phrase ‘ants in the pants’ suddenly jumped up at me. But where did the ‘ants’ go as the session progressed? It was at this point that I jettisoned the medicalized ADHD descriptor. What was it that we were we doing in the session that made him less agitated instead of more?
The only explanation I could offer was that I had asked him to use one hand then the other for a number of tasks, principally to act as distractors, including drawing a 4-looped geometrical figure. To our surprise the other, left hand, was better. But what had this to do with his apparent ADHD? Of course, ‘ants in the pants’ was not an explanation; it was simply another descriptive label. Suddenly the expression ‘ill-at-ease’ occurred to me. Whatever it was that we were doing was making him more, rather than less, at ease as the session progressed and that it had everything to do with his hands.
I already knew that some adults had been forced as children – for cultural reasons- to write with their right hand and were punished if they didn’t conform. They were also expected to eat with the knife in the right hand and the fork with the left. I began to suspect that some children were unintentionally induced to write with their right hand when they were indeed left handed, and that I had just encountered such an example. I felt I needed to introduce more bi-manual tasks and to ask clients to try them with first one hand then the other.
3:2 “Stop rocking backwards and forwards on your chair”.
Within a few months of the above workshop I conducted another home-based family workshop on a primary school pupil but this time with only his mother present. He kept rocking back and forth on his chair. As before his mother asked him to stop rocking. As before, I asked her whether she had ever had to ask him to sit still before. Again I received an affirmative answer. As well as the usual bi-manual tasks I asked him to try doing many of the single handed tasks with his other (left) hand. At the end of the session his mother said that she had learnt that “he needed to be left alone to things his natural way”. The clear implication was that she, like me, had realised that his adept hand was his left hand and not his right.
Comment The mother’s spontaneous “I realize he needs to be left alone to things his natural way” was a damascene moment for me. The phrase “left alone” in this context was the entirely correct reposte to “Do it right!
5: From right to left
5:1 .”.. because it’s my left!”
I was contacted by parents to conduct an evaluation on their son. They were paying for his and his older sister’s private schooling but were concerned that he wasn’t making sufficient progress to enable him to enter the senior school. A participant school observation took place before the home-based session. By now I was deliberately checking to see whether pupils with apparently intractable problems were writing with their non-adept hand. Often when I conducted classroom participant observations I have not met the child previously, and ask specifically not to be told which pupil is the pupil of interest.
5:1:1 The preamble
Before the classroom participant observation I chatted with the Headteacher about the boy. The nub of her comments was that the parents held unrealistic expectations of their son “… because to be truthful, he didn’t have much up there!” (gesturing to her head).
5:1:2 The classroom
Watching the class from a position on the right (from the pupils’ perspective) side at the front of the class I saw three pupils who looked from their posture and gestures that they might be more adept with their left hand. None of them were yet writing. However, sitting on the right hand seat of a front desk in the middle of three rows was a pupil, fidgeting with his iro, while the teacher was
talkin. Eventually it ‘broke’. It was clear from the way he was fidgeting that his right was his holding hand and his left his manipulating hand.
The teacher then set them writing. I watched and waited a little then went first to the other two pupils. The first boy sitting at the back of the class had nearly completed a page of writing and was doing so with his right hand: he clearly wasn’t the pupil having difficulties! I next went over to a girl who was sitting in the row before the back row. She had written several lines. She didn’t appear to be a pupil having any difficulty either.
As I approached the boy sitting on the front row, I could see he had written not a word. I crouched down to his level as I reached him and, instead of asking why he hadn’t started to write anything, I said: “I think I know what your problem is!”. He looked at me, slightly puzzled, and asked how I could possibly know. I told him I’d seen many children like him and I saw that he seemed to have the same problem they had. He was clearly intrigued. I told him we could confirm my guess later at home during the home-based session.
5:1:3 3 The journey home.
The home-based family workshop was to be conducted after school. We had to wait a short while before driving to his home because his mother needed to collect his older sister. His mother and I agreed that since I didn’t know the route, he would sit beside me as a front seat passenger and we would follow his mother’s car. Very quickly we lost sight of her. But the boy directed me home faultlessly, signalling with his hands which direction to turn at every junction. At the end of the drive, he asked me if I knew why he hadn’t told me to turn left or turn right. I said I thought so and that it might be related to why he had difficulties with his school work, but could he tell me why? Rather obviously he said that he didn’t know his left from his right (hand).
5:1:4 Home-based session
As the workshop unfolded it became increasingly clear that his left hand was his more adept hand. The question was: could or would he acknowledge it? One of the final tasks involved juggling with up to 3 balls. I asked him to stand side-by-side with his father, holding hands together and juggling one ball back-and-forth between the outer hands: in effect, juggling ‘as one’. The boy was holding his father’s left hand with his right hand. This meant the father was throwing-catching with his right hand and the boy with his left. At one point the boy failed to catch the ball his father had thrown and reached down to pick it up while still holding his father’s hand with his right. Just as he grasped the ball and while still stooped down the following dialogue then took place:
P: “Freeze!!! Statues!!!”
B: [He froze.]
P: “Which hand is the ball in?”
B: [Without any hesitation] “My left hand”.
P: [Invoking the principle that you know what you believe if you’re able to resist a counter-factual suggestion] “I’m not sure. I don’t think you’re correct. And anyway, how can you be so certain when you said earlier that you couldn’t tell your right from your left?”
B: “It is my left hand.”
P: [By now he had let go of his father’s hand and was standing upright.] “I’m still not convinced. Look, I’m sitting here opposite you and this is my right hand (indicating) and since that hand [pointing to his left] is on the same side it must be your right hand too!”
B: “No it isn’t, it’s my left hand!”
P: “OK, I might be prepared to admit that you’re correct and I’m wrong; but tell me how you know it’s your left?”
B: “I know it’s my left hand, and because this is my left hand, that is my right hand!” [Gesturing]
Comment How wrong was the Headteacher? How, during the course of one afternoon and evening could he be transformed from not knowing how to tell his right from his left, through being able to do so, and being able to resist someone telling him he was wrong (when he was correct)? Of even greater significance was his justification: He did not say “This is my right hand and therefore the other is my left” Clearly his essence had now been rooted in his leftness itself!
6: Which way does it go? (b to d)
One of the questions I put to all clients, children included, is the unusual one of asking them what they think with, not what are they thinking about. I then ask them to write down their answer. The dialogue with this writing with the right handed primary school pupil ran as follows.
P: What would you say you think with, not what you’re thinking about?
P: That’s a good answer. It’s not what most children say, it’s more typical of what some adults might say. Can you now write that word ‘mind’ down!
Father; That’s an ‘n’ not an ‘m’.
B: [Changed the ‘n’ into an ‘m’ then continued until the letter ‘d’ when he drew the down stroke then said] Which way does it go?
P: I’m going to answer that question in a seemingly unhelpful way. I want you to put the pen in your other hand and write the word ‘mind’ down again.
B: ‘m’ ‘i’ ‘n’ [and without any hesitation] ‘d’
P: Excellent. There’s at least one problem with the word ‘mind’. It’s often used when we want people to ‘mind what they’re doing’, or ‘mind their own business’. And Descartes said that the mind and the body were different, whereas I think they’re different aspects of the same thing!
Comment As already stated, not many young children offer ‘mind’ iwhen asked what they think with. The father’s sitting-on-the-child’s-shoulder correction was not required since the letter ‘n’ was going to occur latter in the spelling of ‘mind’. It would have been useful to see whether he would have realized that he’d written the same letter ‘n’ for the two different sounds “m” and “n”and self-corrected. The fact that the boy had done the down-stroke of the letter ‘d’ then asked “Which way does it go?” tells us that he (or perhaps better still, his brain) had an orientation problem. And because we know that the two cerebral hemispheres ‘mirror’ each other, at least as far as motor control is concerned, it was highly likely that he was using the wrong hand to read his mind’s eye image. And so it proved to be the case!
7; The angry and the cool calm collected hand
Many cases involved parents changing their child’s school or even moving round the country to try to resolve their child’s problems. This was another such case. This pupil was seen at home.
As with many other children he didn’t sit still and quietly with his parents and me while working round the work table. Nevertheless he was asked “What would you say you think with, not think about?” he said “My feet”. At that moment he was indeed kicking an indoor football round the room.
I told him that sounded like a good sensible answer since he was indeed kicking the ball around: that’s probably how professional footballers might answer the question too.
But the raging and calm hand incident occurred while sitting on a sofa. The boy was sitting on the right, his mother in the middle and me, on the left. He became visibly distressed / angered at one stage during our conversation. He’d raised his voice and shook his fisted right hand at me angrily saying, “Get out of the room now!”. I prompted his mother to say and do nothing. After a few moments without any further outburst he ‘politely’ said “Please leave the room” but this time gesturing with his left hand.
By not contradicting or correcting his seemingly nonsensical answer to the question of what he thought with, I was validating his ‘off the top of his head’ answer. More importantly by accepting and commending his answer we established a common ground allowing us to go forward together.
When he raged for me get out of the room with his right hand then later calmly asked me to leave the room with his left I conjectured that his left hand expressed his cool, calm rational self while his right hand expressed his hot, raging irrational self. It was this incident more than any other that pointed to the fact that one hand works both literally and metaphorically as the head hand and the other as the heart hand. So one might predict that when the right handed person says “With my hand on my head and the other on my heart…” the right hand would go to the head and the left to the heart. The hand gesture would be mirrored by left handers.
8: I’m prepared to admit I’m ambidextrous.
P was the eldest of three children: one of primary school age and the other two of secondary school age. I had been asked by the mother to conduct regular weekly sessions with the youngest child (R) to stretch her because her school had failed to cater for her high ability with the result that she was behaving badly there.
The workshops were extended for some of the time to include R’s older siblings and mother and father. In these family sessions R showed her talent for being able to ‘wind up’ her older siblings so that they would start fighting, verbally and physically with each other.
I wanted to satisfy my curiosity over why her brother was so susceptible to his youngest sister’s goadings. I noted that the two younger siblings wrote with their adept right hand. This didn’t seem to be true of the brother – he had very ‘untidy’ handwriting.
I asked if P and I could work together to check out his handedness because he was adamant that he was right handed. Indeed at one stage he thumped his right fist on the table while saying, with righteous indignation “I am right handed!” We all agreed on one occasion that instead of working with the youngest child for the whole of the session, I would work with the brother but include his mother and two sisters.
It soon became clear to everyone apart from P that he was more adept with his left hand than his right hand. But he still protested his rightness. At this stage I became like a dog with a bone, desperate to think of a task that would let him see what others could see.
I had already used juggling balls for a different purpose but I thought I’d use them here. I said “Let’s see if I can throw one ball over a shoulder and catch it behind my back with the other hand”. I’d failed with both hands: but at last I’d found an impossibly difficult task!
I asked P to try the task. P failed every time when he threw the ball with his right hand. Surprisingly P succeeded every time when he threw the ball with his left hand. When he threw with his right hand the ball landed nowhere near where he was standing: it hit the far wall or fell well away to his left.
After catching it and holding it in his right hand, on one occasion, I asked him to tell me which was his adept hand. Without hesitating he lifted his right hand and said “My right, look I caught it with my right!”
I suggested that he might be focussing on the wrong aspect of the task. I asked him, “Which hand knew both where the ball was and also knew where the other hand was.?” Thinking it through he agreed it was his left hand, but still said this didn’t make him left handed. The normal session resumed with only the youngest sibling.
About 30 minutes later, there was a knock on the door, P entered and asked if he could come in and tell me something. Not quite knowing what to expect, I welcomed him. I was interested to hear what he had to say. He duly sat on my right with his youngest sister on my left. Then rather solemnly and seriously he said “I’m prepared to admit I may be ambidextrous!”
Comment For someone who was so adamant that he was right handed and who resisted all the evidence that had convinced his mother and two sisters that he wsa left handed his admission was a seismic shift. And ss with all other clients this shift in ‘thinking’ was accompanied with ‘raised’ emotions. With the time available, I was not able to fathom out why he was unable to make the complete shift as had the boy who’d said “It is my left hand”. I could only assume that since he was that much older he had invested more of his life in being right (handed).
9 Self referred and adult evaluations
9:1 … if I can do this, I can’t have brain cancer can I?.
This case occured fairly on in my shift from the conventional approach. It prompted me to use Chinese ‘stress balls’.and alerted me to the role of the hands in determining a sense of self.
9:1:1 The phone call
I received a phone call, in desperation from a woman (W) to book a counselling appointment for relaxation. On the phone W said she had tried everything else but nothing had worked. And for some reason had contacted me for help. I told her I could probably help her but not specifically for relaxation. W said she felt it was her last chance, as she had tried everything else. We arranged a session.
9:1:2 The session
Almost as soon as W arrived she said she had a perfect job, a perfect husband and a perfect daughter! Evidently there was a major puzzle here: why in this case is W suffering from apparently debilitating stress?
W said that she thought she had brain cancer, which none of the specialists she had seen were prepared to acknowledge. She
She had however been convinced by the results of specialist investigations, that she didn’t have cancer of the stomach..
Because her underlying problem had not been identified the cancer had to go somewhere else; and where better than to the thinking brain? When I asked W what her evidence was, she gestured with her hand and saying, look I can’t control the shaking.
After she had engaged in a number of my evolving tasks I eventually thought I should tackle the ‘relaxation’ problem head on. I told W that years ago I had bought myself a set of Chinese stress balls but never used them. I had bought them because I had read they would help defer the effects of potential rheumatism if rotated over the Chi points in the palm of the hand. I also said that I knew some people recommended them as stress-reducers. I said I’ll try to find them.I did find a pair and held them in my right hand rotated them slowly. I asked her if she could do what I had done. W took the spheres in one hand and bcame completely engrossed trying to turn them. I asked her to try turning the spheres in the other hand. She succeeded in doing so but hesitantly / cautiously.
It was while W was turning the spheres in the second had that she suddenly looked at me and said,”I don’t think I can have cancer in the brain, if I can do this, can I?”
I told her that I wasn’t medically qualified, but it was obvious that those parts of the brain responsible for hand control could not be damaged otherwise she wouldn’t be able to turn the balls as well as she was doing.
9:1:3 The possibilty of postural collapse
The session concluded with a discussion about how she was to get home. I was concerned that she might be about to experience postural collapse. Maintaining a normal posture demands a balance being too rigid / tense – such that a mere push would topple one over- and too limp – such that one would only be able to lie down. Postural collapse occurs when one suddenly collapses to the floor because all the ‘tension’ holding the body upright dissipates. I explained this and we considered possible alternatives for her travelling home: her husband fetching her, or me driving her home then her husband returning me back to the office. W said she thought she would be OK to drive. I walked with her to her car and was immediately reassured as soon as I saw her seated. As soon as she placed her hands on the steering wheel looking visibly confident. She had an ‘I’m in control’ posture and her hands weren’t shaking
9:1:4 The hidden story
It emerged that one key to W’s ‘problem’ was that she never got to say the final goodbye to her father. He died of cancer while she was at university taking her Finals’ examinations. She was currently approaching the age of her father when he died. At that time her parents didn’t tell her how close he was to dying nor how fatally ill he was. They didn’t want to jeopardise her future by affecting her exam performance. The proximal trigger to believing that she had cancer in her brain was her uncontrollable hand shaking. She first noticed this while she was running a week-end team building course. A team member told W she couldn’t stay because she had just received a message about a relative dying of cancer and had to leave the course. W was prompted to reveal this story because I commented on the intriguing fact that throughout the session W unable to complete the final part of so many tasks.
10: Ancient Greeks, Common sense, Descartes and Schizophrenia
The critical features are related as four phases:
10:1 Phone call
I received a phone call from a young female adult -K- with a very high pitched voiced – requesting an appointment and asking if we could arrange it to take place at her home, where she was living with her mother. K said she had schizophrenia. I agreed.
10:2 First home visit – the mother
I arrived at her home to be met by her mother who answered the knock on the door..
Her mother told me K was in bed and unable to get up. This was confirmed by her mother taking me to her bedroom door and seeing her head covered under the bedding; unable to talk. Pondering what to do I thought I’d ask the mother if we might go through some of the tasks I would have tackled with her daughter if I had been able to meet her daughter. Her mother agreed.
Perhaps the most revealing response of the mother was to the ‘mirror in my hands task’. The task derived from the ‘Mirror, mirror on the wall, who is the fairest of them all” utterance of ???. I adapted the task by offering the client an A4 sized mirror to be held in the clients’ hands who was then asked to fill in the missing word or phrase, repeating the utterance “Mirror, mirror in my hands who is the …. in all the land?”. The mother got very agitated and angry saying she would not take part in such silly games!!!
During our conversations the mother said that she was so concerned about her daughter’s mental health as she was growing up that she had taken K abroad for various brain treatments over the years, including electro-convulsive shock therapy.
We arranged for me to make a return visit if and when her daughter made the request.
10:3 Second home visit
Some short while later K phoned again requesting an appointment. This time K answered the door herself and invited my in to conduct the workshop.
She talked and demonstrated examles of her obsessive compulsive behaviour. K said she would wash her hands repeatedly, brush her hair repeatedly but most importantly that when she touched the floor she would do so repeatedly. She got into a loop touching the floor because she wasn’t sure whether when she had touched the floor she wasn’t sure whether she was replacing germs (having touched the floor before) or was picking them up for the first time. Rather than trying work out what this all meant I asked her to show me what she meant about touching the floor.
Seated on the chair K leant over, lowered her hand to within a few inches of the floor then sat up, but without touching the floor. I asked her if she had touched the floor. K said she had. Not wishing to contradict her I told her I thought I must have blinked at the moment she touched the floor because I didn’t see her touch it. I asked her if she could do it again, for my sake rather than hers.
Without hesitation K repeated her previous not-touching the floor touching-the-floor action. Working on the principle of the need to validate clients’ experiences rather than contradict them I switched tasks.
Later I asked her to tackle the mirror task I had tackle previously with her mother. I told her to hold the mirror between her hands while looking at herself in the mirror to repeat and complete the
phrase “Mirror, mirror in my hands who is the most …… in all the land?” K was couldn’t or wouldn’t hold the mirror. I suggested that I hold it for her instead. When I did she gave a fleeting glance at herself before turning her head away I asked her on why she couldn’t or wouldn’t look at herself in the mirror. She said she wouldn’t like what she could see. I suggested, in that case why don’t we break the mirror? K said this would make matters worse because worse might lie beyond the mirror! “Breaking the mirror wouldn’t help”.
10:3:1 An insight into what common-sense is.
Driving home I wondered how anyone could possibly say they were doing something, in this case touching the floor, when they were clearly not doing so! I heard her say she was touching the floor but I could not see what she was telling me. She was apparently at ease with her answer. But I wasn’t. I did however know that Descartes said that common sense is when the different senses transmit the same message to the brain. I also knew that the Ancient Greeks also regarded common sense in the same way, namely that what we see agrees with what we hear; and that if it doesn’t the brain has a problem!.
I felt I needed to devise a simple check on ‘common-sense’ with all successive clients. Yet I could hardly ask future clients to touch the floor, but not touch it, then say that they had! Or at least, if I were to ask them to comply, they would perhaps question my rationale / sanity. I realized the essence of the task would be to show them one thing while describing it as something else.
And then it hit me. A pedagogic mathematical activity with young children is to ask them to count the number of fingers we’re holding up. But what if, instead I were to say to clients “Count my six fingers please?” while holding up only four fingers on one hand while placing the other somewhere in sight of the client (eg on my lap or table surface). This would fit the criterion of inducing a mis-match between what one hears and sees. This leaves open-ended the question of how one resolves the seemingly ‘nonsensical’ instruction.
10:4 Several years later
Several years later I recieved another phone call from K. She wanted a follow-up appointment since in the meantime she had given birth to child and there was concern over her ability to care for the child.
On this occasion her partner, but not child was present. During the session we went over some of the tasks with her partner that we had tackled before.
10:4:1 Touching the floor.
I asked her if she could remember describing one example of her obsessive compulsive behaviour, namely ‘touching the floor’? I asked her to show me again what she had then done when she told me she repeatedly touched the floor. To my complete surprise K unhesitatingly touched the floor!
When I told her that was not how she had done it before she was surprised and said she had touched the floor.
10:4:2 Chinese stress balls,
I was seated on the right of the sofa, K sat in the middle and her partner sat on her left. At one stage I demonstrated turning the Chinese stress balls in my right hand and asked her to do the same. K couldn’t / wouldn’t saying she couldn’t hold them. So I asked her to pass them across to her partner
so that he could try turning them in his hand. Said she knew what I was trying to do: get her to hold them, but she wasn’t going to! I admitted that that was my intention.
Instead I passed them directly over her to her partner. He tried turning them in one hand, then at my prompting with the other. I asked him to return them to me. To my surprise he passed them to K, who took them in her left hand, and transferred them to her right and passed them back to me!
10:5 Reflection, refraction and recursion
Not only did the Ancient Greeks define common-sense as when the different senses sent the same message to the brain, but they had a variation in the story of Narcissus and Echo, which involved mirrors. Narcissus fell in love with an image he saw (relected) in a pond. We know he saw an image of himself, he didn’t! Echo was in love with Narcissus but the love wasn’t reciprocated. It was not reciprocated because the conversations between the two were characterised by Echo repeating the tail of what she heard spoken to her. [One of the criteria for severe autism] Unsurprisingly Narcissus stopped conversing with Echo: who after all wants to hear themselves constantly echoed back to themselves?
It was clear from the workshops conducted with both K’s mother and K herself that many of her mother’s modes of action and thought were refracted through K. The “Mirror, mirror in my hands..” task being a prime example.
The best image of recursion is perhaps when one is seated between two facing mirrors and one sees the reflection bouncing back and forth, towards infinity. But of course, when you gaze in the single mirror with an outstretched right hand you see someone looking back at you with their hand outstretched to their left! Believe it or not, when I told K’s mother that her daughter was not right handed but left handed, she replied “Of course she was left handed!” This totally contradicted K’s claim to be right handed!
One doesn’t need to speculate too much suspect that the daughter’s ‘schizophrenia’ was created by the mother’s world-view and dynamics of the interactions with her daughter..
11 In the pipe-line
11:1 Female adult on counselling course: the origin of the “Mirror, mirror in may hands” task.
11:2 EBD pupil who was in a special unit and kept down a year in a primary schoool who said “I want to be a lawyer when I grow up
11:3 Adult examined at County Court Judge request: “Is there something wrong with my brain?”
11:4 Young Offenders’ Institution “This (gesturing string – spinner) was the most interesting thing we did”
Road to realization
Hegemony of the right
Treatment and Implications
Identification and Support