depression

Case Study (CS4) (Catatonic Depression) (Compression-Depression Triad)


March 15, 2018

CONDITION and HISTORY

CS4 is a female client who was approximately thirty-seven years old when she experienced a very debilitating catatonic condition.

She had previously been a client for about a year, coming several times for neck and back tension. She had responded very well to those bodywork sessions, recovering quickly from the minor incidents of a very active lifestyle. She has a stocky build and is very energetic and strong. She raises horses on her farm and she manages month-long horse camps twice a year, during which the participants take long trail rides daily. At the time of her catatonic episode, she was also managing, at her farm, a small herd of Lippizan horses for a neighboring absentee rancher.

About two months prior to the catatonic episode, CS4’s teenage son, her only child, had died in an automobile accident. CS4 suffered badly from the emotional trauma, but, in addition to her husband, she was surrounded by a large loving family and a supportive community of friends. She appeared to be coping as well as could be expected after such a tragedy.

CS4’s husband, who at times worked in another state several hundred miles away, eventually had to return to his job. Although he hesitated to leave CS4 alone, she assured him that she would be fine and that her family would check on her for the week he’d be gone. Everything appeared to go well, but when he returned home at the end of the week, he found her sitting on the floor inside their home in an unresponsive stupor. She was unable to communicate and could not say what had happened to her. There was no apparent injury, and he and the rest of her family believed she had suffered a mental breakdown due to extreme grief.

He sought medical and psychiatric help for her over a period of about six weeks, but she recovered very little, if at all. She appeared to suffer from catatonic depression, or what is now known as major depressive disorder with catatonic features, in which someone who has major depression develops physical symptoms, such as being unable to move or speak. CS4’s main symptoms were:

·      Stupor, in which there is little or no psychomotor activity, no evidence of a connection to the surroundings, and little or no eye contact.

·      Waxy flexibility: a tendency to remain in one place unless moved or led to another one.

·      Mutism: little or no verbal response (inability to talk).

She could follow very simple instructions; she could be led from one place to another; occasionally she could grunt a few words, but she was mostly incommunicative.

When her condition didn’t improve after six weeks, her husband called me to see if I had any suggestions. When I asked him if she had been injured somehow, he said that she had a small scuff on one forearm when he found her, but no other injuries had been observed nor diagnosed. He brought her for a session late the next day.


TREATMENT

When they arrived, CS4’s husband opened the car door for her and led her inside. She was hardly recognizable as the healthy, energetic person I had known. She had a stooped posture with a lowered head and had the appearance of a much older woman. When I greeted her, she didn’t speak. She didn’t raise her head or make eye contact. I took her arm and led her into my office. She was able to follow my simple instructions as I proceeded with my work. The session lasted about an hour and included the basic Applied Bio-Mechanics technic, which works to decompress and align the structure, followed by several craniosacral techniques to further aid in decompressing her spine and cranial base.

CS4 didn’t talk during the session, but her body exhibited relaxation, better breathing patterns, and a loosening of tensions. At the end of the session, I suggested that she lie on the table as long as she liked, then get up and come into the adjoining room. I went out and joined her husband and my wife in the other room.

In a few minutes, the door opened and CS4 peered into the room. While standing in the doorway, she looked around, meeting the eyes and holding the gaze of each one of us in turn. Then, she very clearly asked, “Where’s your phone?”

I pointed to it on a nearby table, and she walked over and dialed a number. When the person she called answered, she said, “Mom, I’m back.” She spoke briefly and normally with her mother, then hung up the phone and sat down.

I asked her how she felt. She said she felt fine and began to talk about her experience, both during the session and the weeks prior to it. She was very animated and bright. She did not struggle to speak at all. She laughed easily and spoke very normally.

She described her anguish at not being able to talk during the previous weeks and how when she had tried, all she could do was grunt. Occasionally, she could speak a few mumbled words, but she said, “It was like crossed wires — my brain shorting out a lot.” She said she was angered and humiliated by the psychiatrist asking her questions, then nodding and scribbling on his notepad when she grunted trying to answer. She said she tried to tell him she couldn’t talk because some wires inside her head were crossed and her jaw was numb, but she could never say what she meant ... only guttural noises came out.

Regarding the bodywork session, she said that “tenseness and shorting out were especially strong in my right shoulder blade area, and there were creaky, electrical noises in my head.” As she grew more relaxed during the session, she said she felt a sensation like “wires uncrossing.” She also described some esoteric experiences. Three or four “beings” had “pulled” her out of her body through her head or neck and had “showed-told-taught me some things” — things about her son, a message for her husband, and answers to some questions she asked. “There was definite communication, apparently nonverbal.” She experienced “knowing” the things the beings communicated. “It was too much, beyond my ability to comprehend. I blanked out. I woke up again in my body — felt stiff and heavy and awkward.” After she got up from the table, her body quickly returned to normal.

(Although she described all these experiences immediately after the session, the actual quotes above are taken from notes she wrote down a short time later.)

I asked her what had happened to her ... had she hurt herself in some way?

She said, yes, that she remembered the whole thing during the session.

While her husband was away working, she was in her house one day and heard a commotion at the barn. She looked out and saw that two prize Lippizan stallions were in a fight. She grabbed her bullwhip and rushed to the barnyard to break up the fight. She is a very experienced horsewoman and didn’t hesitate to wade into the fight to try and prevent the horses from being badly injured. She entered the fray with her bullwhip, trying to separate the horses. Then one of the stallions swung around and kicked out with his hind legs. She saw a hoof coming straight at her head and threw up her arm in defense. She didn’t remember anything after that. She didn’t remember whether or not she fell, or anything she did afterward, including what happened to the horses or how she got back to her house. The horses were not injured, and no one had suspected that they were involved in any mishap.

We talked for a while before they left to return home, and she engaged with everyone and every topic very normally. After this one session, she did not have any follow-up treatments and appeared to be completely back to her usual self.

Through the years since that incident, she has returned for bodywork occasionally, usually for complaints related to neck and back tension. Now in her sixties, she continues to ride horses and participate in the twice-yearly month-long horse camps. In addition to caring for her own farm, she co-manages a family-owned bed and breakfast and remains an active member of her family and community. Though recalling the relief of tensions and "wires uncrossing," she mostly remembers this particular session as a spiritual experience, during which she learned to let go of her son and her grief.


OBSERVATIONS

This case indicates with great clarity how intimately the physical, mental, and emotional aspects of the body are interwoven, and how nonintrusive bodywork can function on many levels to overcome a dire state of dysfunction, often very rapidly.

At the core of the case is the physical injury that this person suffered. Based on her body’s reaction during the bodywork session and her own description of what she felt during the session, as well as the incident with the horses, I believe that she probably suffered a whiplash-type injury and possibly a fall backward to the ground. The horse obviously didn't strike her, as she had no apparent injury, but it is easy to imagine her jerking backward to avoid being kicked and the hoof's grazing the arm that she put up in defense. There's no way of knowing whether she lost consciousness or not, but her lack of memory after seeing the hoof lash out toward her head probably indicates that her state of catatonia began soon after.

Applied Bio-Mechanics is very effective in releasing what is sometimes referred to as a compression-depression triad. Very simply, this type of compression involves the joints of the sacrum, the occiput-atlas-axis, and the sphenobasilar symphysis. These joints can become compressed due to a fall, a blow to the body anywhere (but especially the head), or a whiplash. Symptoms are many and varied, but depression is one of the foremost. Decompression of these joints through ABM and cranial releases will often completely resolve depressive episodes, as in the case cited here.

Another important component of this case involves CS4’s emotions surrounding the death of her son. Often, with the release of structural restrictions, a person will experience memories or have other insights into their emotional situation. The esoteric part of the session, completely internal, helped her resolve her extraordinary grief, and she believes the spiritual guidance she received changed her life. Although she still missed her son and grieved for him, she was able to accept what happened and move on with her life. The esoteric experience she had during the bodywork session was very real and has helped her through other emotional situations from then to now, including the death of her husband several years ago after a long illness.

Recently, I asked her what she experienced during the days following that session.

“There was enhanced imagery and enhanced perception, not just visual. ... I could see colors better; I could hear better. All my perceptions were enhanced. I really enjoyed that. Because I had been so unobservant for whatever period of time that was [about six weeks of catatonia plus about two months of grieving], to be really present in the moment was such a gift. Beautiful planet. We have a beautiful place here. I just remember being so appreciative of that, and appreciative of my life. All the doom and gloom ... was gone.”