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Capacitar and Mental Health Service
David Saavedra, LCSW, McAllen, Texas
During the year of training in CAPACITAR practices through The Center to BE, I applied the techniques I learned with several groups at the health clinic in McAllen, Texas where I am Director of Family Counseling Services. In addition to stress management groups and clinical staff groups, I have used CAPACITAR practices with my individual clients in therapy, in particular the Emotional Freedom Technique (EFT; tapping acupressure points) and Tai Chi. I have used them with clients who have suffered trauma and who may also suffer from panic/phobias.
Using the EFT has been an especially powerful tool. There are two clients in particular who made changes that I consider dramatic. One is a woman in her mid-thirties who was tortured by her husband and had suffered from post traumatic stress disorder and severe depression. It was incredible to see how she even had trouble with eye-hand coordination when doing the EFT. After spending an hour walking her through the exercise she was able to do it and with significant results. I met with her for a follow-up appointment and her affect, ability to talk and her level of hope were dramatically changed. She experienced for the first time in her life some relief of her pain from the damaging results of her torture and abuse.
The second case is an immigrant family with an 11-year-old boy who was traumatized by a home invasion when he was 6. He and his father were beaten up and an elderly neighbor was killed in their home. This occurred two weeks after the family had moved from Mexico to the United States. This little boy had not been able to play outside of their home at night because of severe anxiety and also wet his bed on a nightly basis because of his fear of the dark. He had also become aggressive with his brothers and sisters. Since the parents were primarily concerned about their son, I discussed the EFT and the roots of energy work and asked him if he was open to trying the technique. I also had the parents participate, which they were very open to doing. Right away, all three experienced symptom relief for each of them and the young boy appeared to be very eager and fascinated by the idea that he could get better. He also suffered a great deal of shame and low self-esteem about wetting the bed and not being able to play outside at night like most children. By the second session, my client was able to play outside in the dark and was staying dry at night. If he needed to go to the bathroom at night, he was able to get up and go without the terrifying fear. After four sessions, he continues to do well and is basically symptom free.
Capacitar Practices for Mental Health
Kay Middlebrook OTR Austin, Minnesota
In March, 2007 I began a wonderful journey. I had been working as an Occupational Therapist in Minnesota for over fifteen years when several of our hospital administrators met Pat Cane at a Leadership Workshop and learned about CAPACITAR. They made a commitment to transformation and healing in our medical center that led to the creation of a "Wellness Practitioner" position on the acute psychiatric unit. With my 30 years of experience working in behavioral health I was excited by the prospect of exploring wellness and healing using the skills of Training in Healing and Transformation. The goal of this pilot project was to develop a wellness program using CAPACITAR as a model for both patient and staff self care.
I began CAPACITAR Training with Pat Cane at The Center to BE in Milwaukee. For the required practicum, I worked with a variety of adults on the inpatient psych unit including nursing staff, social workers and patients with a wide range of psychiatric diagnoses. Three mornings each week I gather all of the patients for a 30-45 minute Wellness Group. I teach a variety of self-care practices based upon patient needs, numbers, space requirements and group energy each day. Discussion, demonstration and practice are a part of each session as is a closing ritual, which allows group members to share feelings and thoughts about the experience as well as offer feedback. The goal of the group is to provide patients with a "tool box" of simple mind/body practices that they know well enough upon discharge to practice on their own. We focus on repetition and provide handouts to support individual practice. The techniques that are most often requested include deep breathing, imagery, the finger holds, head holds (especially for those who experience chronic headaches), and Tai Chi movements with music.
Acutely ill patients are sometimes too disorganized or unable to function effectively in the group. I provide individual sessions with them and use a variety of techniques specific to their needs that may include head holds, hand massage, spinal rocking, imagery and acupressure for pain/headache management. Individual staff members ask for assistance with their own headaches, shoulder tightness, etc. and increasingly, for assistance with calming patients that they feel are escalating and demonstrating intense emotion.
I have no doubt that acutely ill psychiatric patients benefit from practice of these simple and direct self-care techniques. They calm, focus and smile more often. Patients have gathered in small groups in the evening on the unit to practice Tai Chi without staff. I have heard patients naming the Tai Chi moves, i.e., "Spirit Fingers" for the Shower of Light. Staff ask for assistance and information about self care practices. Nursing students attend and participate in the Wellness Group learning new ways to practice healing. The skeptics tease and use humor as they look for purpose and proof that these self-care strategies are effective. The questions posed regarding the use of complementary healing practices are gifts that will feed the discussion and expand our thinking about how to more effectively engage each patient in their own healing. I am happy to be a part of the process.
Capacitar in Group Homes
Judy Jones—House Manager at Robert Berry House, Fond du Lac, Wisconsin
I work with the residents and staff in a Transitional Group Home for the mentally ill. One of the biggest challenges the residents face is managing the symptoms of their illness. It has been exciting to introduce Capacitar techniques as another modality to help them deal with their illnesses.
One young resident has extremely low self-esteem and suffers from a Disassociative Disorder. When stressed her mind separates from her body and she cannot feel anything physically or emotionally. Consequently she engages in self-injury practices to break the cycle, to feel something and to punish herself for her thoughts and inadequacies. I decided to try the head and heart holds we learned in the training to try to calm and center her. She immediately reported that the pressure allowed her to feel her head and helped to reconnect her. We started using simple polarity moves when she would become stressed and would seek out staff to help stop it before she got worse. We then added the joint moves and she would become extremely relaxed and you could just feel the tension leave her body. She was instructed just to concentrate on the music and pulses. At one point she suggested I perform this protocol on a staff member who was having a particularly stressful day while she observed. The staff member had an extremely positive reaction to this and the resident stated she felt better knowing that these practices could be for anyone not just someone "sick" like her.
I also taught her family some of these moves one night when they returned her to the group home. She was disassociated, hands clenched, breathing rapidly. By doing the head hold she started to relax, and eventually her breathing slowed. Her parents felt comfortable in doing this. Then her mom and I massaged her hands while talking about how she was dealing with her illness. She eventually was able to join the conversation and tell her parents how else they could help her.
All the staff have been exposed to practices like the finger holds, hand massage, head and heart holds. They are able to help this resident and others use the practices during difficult times and seem grateful for them as alternatives.
Hospital Work with Behavioral Health and Therapy Groups
Lucy Christopoulos, R. N., Psychotherapist, Wisconsin
My Capacitar group has been meeting at our hospital weekly for one hour over the past ten months. Group members are patients in the behavioral health partial hospitalization program and attend various therapy groups daily. The group is entitled "Holistic Health Promotion", is co-ed with members ranging in age from 16 to 85 years. They are being treated for a wide variety of problems, but generally include symptoms of anxiety and\or depression. I chose this group because of the accessibility for me to be able to continue on an on-going basis initially; however, with the good reception that I have experienced by providing this group, I feel mental illness cannot be treated solely with cognitive therapy and medication to be completely successful. The Capacitar practices offer individuals increased control and comfort with their "disease".
My greatest challenge faced is the continual turnover in group members with fluctuating lengths of stays. Members participate in our group anywhere from one to six times, so I like to expand with more practices with returning members as well as introduce to new members the basic concepts.
The practices that I use vary according to member needs and capabilities. Breathwork and guided imagery I use with new members, connecting it to the medical model with some discussion of mind-body-spirit premises. With repeat members I add acupressure and energy tapping. Sometimes I get special requests to repeat previous topics or the group naturally heads toward where it needs to go, so I keep the format flexible.
I receive my feedback informally from about one quarter of the group either directly from the members following the group or by report from other staff. Comments have been quite positive, generally focused on how members like an alternative choice to pills that are readily within their grasp. Following breathwork and relaxation techniques, it is typical for members to start sharing how simple and effective this works immediately. I have received several follow-up calls weeks later from members in gratitude for adding this new comfort to their lives that they have continued to practice and expand on their own.
The most recent anecdote of this is from a woman who left me a voice message over the weekend saying how she needed additional medication to control her "new manic feelings"-this woman adds new symptoms on a regular basis and has made it the primary focus in her life, so it was a very typical message that I have heard for ten years from her. The amazing part was hearing another voicemail from her left three hours later saying that she did not need more pills after all. While waiting for a response she decided to use some of the practices from group and decided that she must have "just been anxious, because I was able to feel better on my own"! Yessss!!!!!
As a behavioral health nurse for 25 years, I feel much satisfaction in being able to offer people an additional way to help themselves and others, improve the quality of their lives, decrease their suffering and feel a new sense of control in their future.