luni, 29 aprilie 2013

THE PRISON OF OUR MIND – AN OBSTACLE FOR THE AUTISTIC CHILD THERAPY . My MIFNE Experience



 „The world needs autism”– it is an article written by the great American writer William Stillman, which I have recently discovered while I was trying to find answers to some tormenting questions related to the spiritual domain of autism. Globally, the number of autism cases is quite alarming. The word „epidemia” is rumored and panic installs.  We live in a time when modern medicine continuously comes up with discoveries of its possibilities and capacities, which sometimes reach the borders of wonderland.

However, no cure has been found to this disorder called AUTISM,  even though the first cases of autism had been identified back in 1943. Autism may have a meaning, if we approach it in a holistic manner and if we try to discover a meaning in it. A medicine hasn’t been found yet is due to the fact that we should have a different manner of understanding the meaning of this development disorder on a global level and different intervention methods. The understanding of autistic symptoms and psychotherapy turn the autistic child in a perfectly functional child as long as we consider and acknowledge his or her special needs and innate abilities, respectively his or her gifts.  

I am a clinician psychologist and through the optics of clinical psychology, the diagnostic sets the person in a certain pathology thus reducing your sight by using such „lenses”. When we hear about a child with autism we already know, actually we think we know, the way he/she is going to behave, which are the distinctive features of his/her disease and we immediately set him/her within the category of thousands of children suffering of this disease. His identity therefore dilutes even more. We keep on searching  until we get lost in details, without being able to see the WHOLE. We are the prisoners of some concepts, living in the prison of our mind.  For a while, I have experienced „detention”. I used to learn about autism and the more I learnt the more I deepened into symptoms, sometimes saying:
 „He cannot do this, he is just an autistic child”.
”It is so characteristic to him, I cannot expect anything else from him. No matter how hard I tried, he is still an autistic person”.
„He won’t wee in the night pot, as he obviously shows an atavistic fear towards it.”
„He cannot love as he is autistic and he all know autistic people are unable to love.”
„There’s no point touching him as he rejects being touched.”
„ It is easy to note he doesn’t understand a thing of what I am telling him, he is just an autistic child.”
„I can do everything I want in front of him, he has no eyes for me.”
„Autistic children are interested only in puzzles, it is useless to try anything else, he just doesn’t like it.”
„He won’t stick his hand in the scum as he is over sensitive and he feels the scum like a terrible pain on his hand.”

And thus the evidence is that an autistic child cannot do anything of what a child normally can.

I was looking at symptoms often forgetting about the child. He and the disease were one. Then I started to learn therapy methods and I came upon an ABA manual... A huge manual with clear explicite exercises and suggestions. It was a time when ABA had hardly gotten in Romania (2004-2005) and there were no specialised therapists but in Bucharest and they were very few.

Nor there was much known about the disease in Romania. I started working with diligence.  Days were passing by and progress was obvious. The condityioning worked just fine. The child reacted so he would get the reward/prompt. What sense did it make that he knew nothing about who I was or who HE was? It didn’t really matter what my inner needs were and what I felt in there, next to that child, prompting him and ticking Xs on a tiring sheet of paper, as long as I had to work on a manual which would guarantee my success, the child’s happiness and his parents’ happiness.  I was working in an artificial environment and I alienated from him and from myself, but I had no other options.

Each new ticked item of the manual was another brick laid for a human who would soon function like a ROBOT, and our faith was within his hands as he was the one who would replace today’s generation. We learnt how to name the cup, the spoon and the sock, we learnt how to react to the orders „stand up” and „sit down”. We learnt to make associations, to fit, to categorise. I could not see the final goal as the manual was vast and I was thinking it would take me years to work it entirely.  Not to mention there were things that didn’t make sense or the child would resist, he wouldn’t cope. I had been working on concepts for months and he, the autistic child, was still indifferent within a RELATIONSHIP.  No point in talking about attachment. The child was still disharmonic. The chapters about how to teach emotions and social interaction were far, though the child in front of me was a social being EVERY SYNGLE DAY. I felt I lacked encouragement and giving up was haunting me. At a certain point I was determined to put an end to this chapter of my life and change focus onto a different career.

I said to myself I wasn’t sufficiently prepared and taht I had to be patient.  I said to myself there was not the case to feel what I was feeling, that there was no point when it came to the autistic child.

ABA works, there is irefutable evidence, so there must be something wrong with me as I don’t feel this is the right way for me. And yet, something deep inside me was whispering that I was right. It was the voice of the child within myself crying for the freedom to think and feel.  The psychologist Claudiu Ganciu wrote in an article: ”The hope that an autistic child may be integrated through ABA is rather a social hope than a psycho-therapy approach. This does not mean that ABA or other methods don’t turn out well, but that these don’t mean to be a therapy, rather an adaptation. In other words, you have a toothache and you get the best results treating the pain, but without treating the tooth cavity.

To make a parenthesis, I have once seen pictures of Probo the Robot, a very expensive invention to which children respond in a friendly manner. Probo mimes feelings and the children react to him, they caress him, but they are unable to caress a human being  (because they are afraid of their own feelings). And it is not their fault  but ours because we don’t strive enough to help them express these feelings or we just don’t know how to express our feelings.

In the autumn of 2005 I received an invitation to a seminar in Predeal, where we were to meet some specialists and their approach to the autistic child intervention. The Mifne Centre of Israel and the inventor of this method, Hanna Alonim, came to Romania to tell us about the theory of attachment in the psychotherapy of the autistic child. The name of the centre did not ring any bells to me, as in my opinion, if there was no ABA, then there was nothing- I thought. However the word attachment drew my attention and I said to myself: „Attachment? I cannot see the connection. The autistic child shuts himself into his shell, what might be his connection to attachment? He doesn’t look as if he needed the people around him.” So I decided to participate, as it sounded like a really exciting subject. Two days of seminar caused a real emotional tsunami difficult to describe in words, both for me and for those present in the seminar room. I went back home extremely confuse and happy to have had such an experience.

It was a miracle I had never dreamt of being part to, as the three - week therapy for one family cost 15,000 dollars, amount impossible to raise at a very short notice. However nothing could stop Sebi’s parents because they were deeply convinced that the method in cause was unique in its approach. Six months after the seminar, I was flying with Sebi and his family to Rosh Pinna, Israel, where we had an appointment for intensive therapeutical intervention.

Autism is basically a relating disorder. I knew children with autism are capable of DOING various things. I had left to Israel deteremined to learn how TO BE with them. What I hadn’t understood to that point was that I could not BE with them because I wasn’t giving them this chance! I wanted to change the autistic child without showing him that I accept him first. He was communicating with me through his autistic symptoms, I had neither eyes to see him nor ears to listen to him. The prison of my mind made me purblind. I have recently read an article on a child named Radu who lives between two worlds. This article comes as a confirmation of the fact that if we are willing to LISTEN to them, these children have a clear message for the world. (http://www.jurnalul.ro/campaniile-jurnalul/copii-speciali-intr-o-romanie-autista/radu-copilul-din-doua-lumi-507159.html).

A great team of calm smiling psychotherapists were waiting for us to cross their center’s threshold. They would be all to our service for three weeks, only dealing with our needs. And believe me, we sometimes feel embarrassed, as we, the Romanian people haven’t been raised to get to know our own needs and express them. We stepped in with faith and with the hope that we would go through an experience which would help Sebi, who was 4 years old back then, to open himself to the world, PRACTISING THE COURAGE TO EXIST.

It was the turning point of my life and I believe he will say the same thing one day. It is there that I learnt the autistic child is a person not an object, a person who deserves to be treated with respect and dignity.  It is there that I learnt to look inside myself and discover myself in relationship with the autistic child. It is there, too, where I LOOKED at Sebi - the child and no longer Sebi - the autist. Day after day I would discover a Sebi who WANTED and COULD, because he felt accepted and capable of breaking down the wall between HIMSELF and the WORLD.

It is there that I experienced the most intense and the deepest emotions ever, next to Sebi and his family. It was a difficult long-lasting labor. We were not told what to do, we were let to observe the psycho-therapeutic process and to ask questions when we did not understand or we did not get a clear picture. The entire therapy was focused on building up the therapeutic relation (attachment) and on creating the unity of the autistic child’s EGO encouraging the freewill. He was always given the possibility to choose. Any therapeutic activity was meant to diminish the child’s anxiety and to develop his co-operation with the therapist. In addition emphasis fell upon the development of personal autonomy, offering the child the appropriate environment to observe himself, to perceive himself, to understand himself and to the LISTEN TO HIS BODY. 

When time came for me to enter the therapy room of Mifne Centre, I was to act according to what I had seen and felt until that moment, during the long observation hours, behind the mirror-window. I met Sebi again under different circumstances. I was to be MYSELF, I was no longer playing a part. I had been observing the therapists’ behavior and I had understood they were very careful concerning their actions, what they felt and the child’s reaction. They were a MODEL, being aware step by step of their behavior inside the therapy room. BEING SELF-AWARE AND AWARE OF YOUR BEHAVIOUR every single moment requires a considerable effort and it can sometimes cause trauma. I found myself in the situation of choosing and deciding what activities to perform with him so as to reach our therapeutic goals: development of self-confidence, development of communication abilities, choice offering, development of inner motivation within the autistic child to make him voluntarily involve in various activities encouragement of any sort of initiative. 

I was able to put forth my freewill. Isn’t this somehow what I actually wanted? The child within myself was coming back to life, was growing along with Sebi. I learnt to reconstruct my relationship with Sebi and to relieve myself from behind bars. I practiced enthusiasm, so that Sebi could understand it and I also practiced the joy of living so that it would serve as a model to Sebi. 
I dug up looking for love and I found a volcano boiling there just for himself. I practiced self-confidence so he could trust himself. I offered caress, as I did not feel at ease on his touching me. I learnt what giving confidence - to help him out of his lack of confidence- meant. I learnt to recognize my fear so he could recognize his.  I also found within myself the flexibility which would help him adapt easier too this world. 

IT IS THEN, TOO, THAT I BECAME AWARE OF THE PRISON OF MY MIND. At a certain point, I chose out of the cabinet full of tempting games a set of wide colorless wooden sticks. I started offering them to Sebi, one by one, to pile them up overlapped. It was all that I could figure out to do with them at that specific moment. I would lay one stick, he would lay another one on top of it. And while I kept doing it, I started to become aware of what I was actually doing. We were getting deeper into the NON SENSE. Ever since, all my actions have acquired a meaning. That was the only way I could help autistic children give a meaning to their actions, discover their own self.  And even though I sometimes happen to lay my hands on colorless sticks, I will use them to make a fence around an orchard in flower, around a crystal - clear water fountain or TO MAKE UP A BRIDGE TO UNIFY OUR SOULS.

I took up this road with joy but also with the lack of confidence of the person who strove to change these children for a while, using different methods (art therapy, game therapy, pictograms, ABA manual – which are otherwise very good methods that I sometimes use to inspire myself). However, every time, when using these approaches, I missed the whole, the whole picture. I found the whole in Mifne approach, understanding the past, the present and the future in other terms than until that time. The Mifne Centre is now treating children who have been diagnosed with autism by the age of two. The specialists at the centre reached the conclusion that these children can fully recover. When they treat babies (6-12 months) the improvement occurs every hour. Sebi was 4 years old and had behavior patterns and intense stereotype behaviors which were difficult to replace with socially acceptable behaviors. However, his evolution was spectacular. 

And after 3 weeks when the gates of the prison of our mind were easily but surely opening, breaking lock after lock, we went back HOME. What a blessing but what a long way to go! And I didn’t even have a manual- just the emotion of a new start. We were about to fight against wind mills but we did not lose our courage. Sebi, treated with respect and dignity, went, in 2006, to a place where children with disabilities can find their place only in the distant kindergartens in the suburbs or special schools. After 4 years spent at the kindergarten, Sebi is now in the third grade at school. He loves people and wants TO BE next to them. He knows who he is and continues to give a meaning to the world he lives in, changing destinies around himself.  

When I returned from Israel, I felt I was upside down. I was doing psychotherapy without being a psychotherapist. It is somehow part of my lifestyle. I had another long way to go. The Adlerian School of Psychotherapy pervaded my soul and it contributed immensely to the creation of my general vision concerning the psychotherapy of the autistic child and his family. We are now a team of enthusiast therapists treating the autistic child with dignity and respect during his struggle to GIVE A SENSE to the world he lives in and to get to know HIMSELF.

Thank you Hanna Alonim, a brilliant mind psychotherapist, and Mifne Team for all your professional work , for your love and and for this huge opportunity!!!  
                                                         

                                                           By Sinziana Burcea
                             Principal clinical psychologist and adlerian psychotherapist
                                                                 2013

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