PSYCHOTHERAPY BEYOND THE FRINGE, continued
One of the occupational therapists had a lovely talent for drawing. Felicity explained his problem to her and asked her to draw a long series of ‘representational’ forms ranging from some which clearly represented something specific and concrete (the first one was a picture of a coat-hanger), through some which were moderately ambiguous (could be a rising or a setting sun), to some which were really quite ambiguous and could be almost anything. Felicity realized that Sarah might not react well if he, as a male, undertook the treatment programme with her. He arranged for his female psychometrist to do the task. A lamp, operated by a foot switch controlled by the psychometrist, was set up under the desk at which they would be working. The lamp could be turned off or on, and when it was on it could shine either a red or a green light up the wall behind the desk. Felicity was sure that Sarah found the colour red disturbing and aversive based on how she had responded to the Rorschach. The task for Sarah was to be to ‘handle’ the stimulus ambiguity (to respond quickly), the stimulus generalization (to respond at an appropriate level of abstraction or generality), and her own pathology (to give a response which was appropriate – that is, similar to responses others gave to a drawing). If she managed to accomplish these tasks well enough, the red light would be turned off and the green light turned on for a short time (as both an aversion-relief and a positive reward).
Of course, both the ‘meanings’ of the cards to other ‘normal’ people (in this case, staff) and of the red and green lights as possible rewards (for Sarah) had to be tested first. A lot of staff were helpful in giving their ‘meanings’ for the pictures until the psychometrist felt she knew the range of ‘acceptable’ response to each. And a brief ‘test’ exposure to the coloured lights with Sarah quickly showed she hated the red light and quite liked the green.
Treatment was started. During the first many sessions, only one criterion was applied to her responses in order to warrant the reward of turning off the red light and turning on the green – speed of responding (handling ambiguity) or concreteness of response (handling generalization) or common responses (handling her pathology). As she mastered each criterion separately, the task was made more difficult by requiring two out of the three criteria to be met for the light to be changed. Once she was adept at that, the task was changed so that she had to conform to all three criteria to have the light changed.
With the help of the insistence of her psychiatrist, Sarah persisted bravely in attending the sessions and in solving the riddles posed to her by the psychometrist. About half way through the programme it was reported that Sarah had suddenly taken to watching anxiously out of one of the ward windows in the mornings to see her psychiatrist arriving at work. As soon as she arrived, Sarah gave every evidence of relief and was able to go about her daily activities. Soon afterwards, Sarah gave strong evidences in her psychotherapy of an intense dependency on her psychiatrist. At last, that allowed the psychiatrist to use the developing relationship for therapeutic ends, and she began to discover a number of remarkable features of Sarah.
Everybody knew that Sarah walked around looking down at the floor. But nobody was aware that Sarah had not seen a human face since the age of six when she had taken to avoiding looking at others out of sheer shame and guilt. Nor did they know that she recognized people from their shoes. Nor had she ever to her knowledge raised her eyes to see a rainbow. It was wonderful indeed to see Sarah suddenly exploring her new found world with excitement and fascination – reading about rainbows and other wondrous things of her world, and raptly exploring the intricacies of the human face in precious detail. She was like one, blind from birth, who suddenly had vision. Many of the staff wept with joy to see her new found freedom. Felicity joined joyfully in the flood of tears.
Sarah progressed well in her psychotherapy until, after about a year following the introduction of the GAPE procedure, she was discharged from the hospital as recovered. She was followed for a couple of years by her psychiatrist as she took courses, obtained employment, established a group of friends and, finally, met a man and later married him. The bright-eyed, happy smile on Sarah’s face each time she was seen visiting the hospital or in the community spoke more clearly than words about her obvious recovery and the joy of discovering normal life at last.
PSYCHOTHERAPY BEYOND THE FRINGE, continued