Reduce Spasticity with Neuroplasticity

 

       Of all the "my friend Jane" stories, one of the most impactful to me, is about one of Jane's spastic quadriplegic cerebral palsy clients experiencing the benefits of Neuroplasticity with Hypnosis and Solution Focused Brief Therapy. (*names are changed to protect confidentiality*)

 

       The story is about one of the most memorable clients my friend Jane has ever worked with, a young, adult female with a diagnosis of “severe spastic quadriplegia cerebral palsy”. “Never work harder than your client” is what we learn at university, and from supervision. This client, one of her first, is a bright, funny young woman with a dead on sense of timing for a punch line. Folks tend to miss that about her because she is “locked in” a body that twists, jerks, and is strapped into a wheelchair, her limbs constantly jerking and tightening in spastic movements. Often making it difficult to even say “hello”. 

       This was also Jane's first client with a physical disability, and she had no idea how this therapy would look, what the goals would be or how any of it would work. Sensing the client’s willingness to connect with her and be open to the process, she jumped right in, and started the work… this client always worked harder than anyone!  Once the client grasped how the exercises work, she sailed above and beyond any expectations Jane may have brought to the sessions. The results of the work they did together-both considered phenomenal. In addition, after viewing videos of some of the work, Jane’s supervisor called the work “groundbreaking”, the theory and application of neuroplasticity providing such startlingly visible results.

                Creating new neural pathways, new ways to connect the mind and body, and new ways for the brain and the body to send and receive signals were the ultimate goals of their work together. For example, at session one, the clients fists were so constantly contorted closed, her knuckles remained white. At the same time, her arms were contorted close against her chest, her left arm so tight against her breast that the pressure caused a white line and then redness in the skin. By around session four, under hypnosis, she was able to relax her arms and hang them down to her side, her hands opening and stretching. Sometime after session five, her mother emotionally shared that the night before, was the first time she had ever been able to hold her daughter’s hand as they lay in bed and talked-no tightly closed and contorted fist that night.

            After that, the work became much focused as the client’s goal crystallized; she wants to be “a real person”. In her ignorance, Jane assumed that meant not being in a wheelchair. Upon exploration, she learned that it meant being like any other 23 year old female: To be more social, to have friends, to eventually not live with mom and dad, to go to college, to have a boyfriend, and so on. As they collaborated to create small chunks of things to do now towards those goals, the client clearly defined a few areas to work on. She wanted to build on being able to relax her arms and hands, to gain control enough to manage a joystick. This would allow her to transit to an electric wheel chair and exponentially begin to have more independence (in her youth she had one and both were convinced that her “tissue had memory”). This work began with breathing exercises. Breathing into relaxation led to progressive relaxation as well as guided imagery exercises. She quickly learned to access an inner state where she could find herself, in her mind’s eye, operating a “magical joystick”, or lounging on a beautiful beach, and anticipating the cute waiter (she was “boy crazy”-so Jane used it!) bringing a tray of her favorite adult frozen beverage, strawberry margaritas! Fascinated, Jane watched as her client reached out with her open hand to operate a “magical joystick” that existed only in her imagination, or as she outstretched her arm to take the margarita from the (imaginary) tray and bring it to her lips. 

      These results inspired them to work on creating these “mind’s eye exercises” that would mimic and enhance the muscle activity needed to be able to eat and drink with minimal assistance, in addition to using a wheelchair joystick.  As the work continued, Jane began to notice that, generally, the client was not in the tight fisted, arms across the chest position she maintained when they first met. As she was wheeled around, now, she usually had elbows on the rests, hands up and opens-as if to wave or beckon to others.  She also seemed much more open and able to interact with strangers. She enrolled in a college class. She was measured for a new wheelchair. She saw a neurologist for botox in her arms to enhance the muscle control they were working on. As they enthusiastically continued their work together, they added more layers; her client wanted Jane to create some audios for her around controlling the pain from the spasticity, and to enhance sleep. Most importantly, she wanted to work on enhancing her communication skills as an important step to becoming more social.         

                The spasticity of her jaw and tongue muscles made stringing vowels together difficult, much less words, and sentences. Yet, under and after hypnosis, and her always successful “mind’s eye exercises”, she could not only string vowels together, but whole paragraphs! This client has a LOT to say…when she is able to say it.   By the end of the semester, this client achieved much mastery in her own…call it what you will...Neuroplasticity, self hypnosis, “mind’s eye exercises”, healing, or growth- particularly in connecting her own mind and body. The work she did, the growth she achieved, and the “muscle mastery” involved create a dynamic atmosphere for future planning for her in realizing what her future looks like, and truly being “a real person”. For Jane, the experience of their work together joyfully resonates within; shoring up her confidence in trusting the process, and using whatever it is the client brings to session, knowing that new ways of thinking can create new connections between the mind and body.

                If a “locked in” client can enjoy such positive change in her life with such a relatively affordable, user friendly, holistic and non-routine therapy, think what it could for someone struggling with less challenging issues! The literature not only supports Hypnosis is effective, affordable and credible but also highlights a need for much more, and larger studies in this area ( Mauersberger, et al, 2000). 

                As Jane and I continue in growth and honing our craft, our experience is exponentially enriched working with all kinds of clients. Further, I am convinced that the results this particular client experienced are not an anomaly. These results are not unique. These techniques and beneficial results can and must be duplicated as we move toward holistic and collaborative approaches that provide helping, healing and positive change in the most accessible, affordable and solution focused ways. Most importantly, these approaches must be made accessible and affordable for everyone, particularly for those who find themselves “locked in” an uncooperative body, or any other circumstance that is an obstacle for wellness and independent living. 
      I look forward to continued growth and learning in my craft and within the spastic quadriplegia cerebral palsy client population, enhancing Neuroplasticity, reducing spasticity and encouraging growth toward what ever it means, to anyone, to be "a real person".