Psychotherapy Out of Bounds

PSYCHOTHERAPY Out of Bounds, continued
An Uncertain Certainty
Trina was a girl in her mid-teens who had been blind from birth. Her parents brought her to see Felicity because, as they put it, ‘she was afraid of the darkness in which she lived’. Felicity had to meet this girl. “How,” he thought, “can a person fear the dark when it is the only thing she has ever known?” His question was answered as soon as he saw Trina. She was markedly uncoordinated, presumably related to cerebral palsy (CP).
A blind person has to organize the world in which he/she lives by organizing her movements (kinaesthetic muscle sensations) and her contacts (tactile sensations) in and with it. Trina’s lurching and poorly coordinated actions would necessarily create highly unpredictable contacts with the things around her and thus an image of unpredictable relationships among those things in space. The result would have to be a high level of uncertainty and thus ambiguousness in her world. And ambiguity is the universal source of fear – everybody experiences fear in ambiguous situations.
Felicity did not know what he could do to help her to feel less anxious since his methods used visual images. But he thought he might be able to diminish the spasticity of her movements. The hypothesis he had was that irritability of her brain (see later) might account for her spastic movements. If that were true, then reducing the brain’s irritability might correct the spasticity of her movements. She might then be able to organize her world better by means of movement and touch, and the fear of ‘her darkness’ should subside. Actually, Felicity had tried, with some success, to reduce the spastic movements interfering with Tom’s life – another CP patient Felicity had treated a year or so earlier.
Sterman’s biofeedback treatment method, which had been used with Chester, was started with Trina. Two EEG electrodes were attached near the C3-C4 sites on her scalp. Then, every time any sensorimotor rhythm (SMR) was recorded in the EEG, a whistling sound was turned on automatically, and it lasted as long as there was SMR activity being recorded from the sites. There were about ten half-hour sessions, during which Felicity observed some learned increase in the amount of SMR activity in Trina’s EEG.

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