From Patient to Therapist
A Personal Story
By Menachem Mendelovitz
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THE 5 CONCEPTS
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Basic Moves are used to introduce this concept. They "teach" the patient's body to feel the Principles of the Concept. While establishing contact between the patient and his body, they also help the contact between the patient and the therapist. Aligning the patient's body into an exercise posture - through either verbal guides or a light touch, if needed - the patient becomes aware of the muscles that take part in the performance of the exercise, the muscles that should not be involved, the correct distribution of tonus between them, and harnessing breathing and the water to support the body and relieve the skeleton of its burden. While performing an exercise, a skilled therapist can notice the spots where the patient has a hard time reaching the correct position, the location of compensations, breath difficulties, and so on.
Performing the Basic Moves is not easy for patients with muscular problems, such as me. It is not always possible to bring the body into the desired position. The muscular distribution of burden is disproportional, and certain muscles "refuse" to take instructions from the brain. In previous aquatic therapies I received, the difficulty of performing even the simplest move in the water drove me to frustration and despair. Even in my first Jahara® sessions, I could not really connect to Basic Moves and viewed them as simple gymnastics. Change came in my fourth or fifth session.
While performing the active exercise of 'Position One back to the wall', doing it mechanically since I was "familiar" with the move, I listened to the therapist's explanation. Instead of trying to force my body to follow my mind's orders, I tried to concentrate on the sensations that my body was sending to my mind. Was the sensation of my left foot the same as my right foot? How much power was needed to make both feet feel the same, and where do I draw the strength? How much muscle tonus was needed to keep my head straight and forward? How far can I let it go while still keeping the sense of vertical balance? As this dialogue between my body and mind was going on, I started feeling a balance inside my awareness. It was a sensation that influenced my posture using not the power of my muscles or the position of the skeleton, but breath and the water's support and buoyancy. It felt as if my consciousness was guiding my body through the new environment it was in, setting the right dosage of force I should use to maintain balance in it. Naturally, while in the water, the body needs much less strength than on the ground, and yet I noticed that only when I became aware of the sensations of my body and its surroundings did my body change the way it carried and held itself - going from "land holding" to this new, "water holding". The sense of relief I experienced - felt in every muscle that did not have to be activated to stabilize my body nor tensed at low tonus to compensate for the weakness of other muscles - can only be compared with a sensation of flying.
Even today, a year after I started practicing the Basic Moves, aligning my body positively is not instantly conscious. With time, it indeed becomes easier for the mind to analyze its situation in the water (see the next chapter), but the muscles that take part in carrying and holding the body still have a hard time performing, even in the water. The fact that I assumed responsibility for performing the activity did not strengthen my working muscles all at once, nor did it revive atrophied muscles, but it did make me feel something I have not felt for 15 years, since my condition deteriorated: I was telling my body how to perform, not the other way around.
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Coming directly from the Concept of Support, this feeling also transformed the way I see my everyday life. Today, at the age of 47, the progress of my illness still lets me lead a normal life. I use no aids or instruments for my daily functions, which, even if limited, include every essential activity. Five years ago, I had a mental crisis that was the result of, among other things, my "acknowledgment" of the fact that my illness has picked up pace. Attempting to recover from this crisis, I started working to preserve whatever muscular ability I had in every way I could. Muscular atrophy is an "ironic disease." Even though I know it exists and is constantly evolving, I find myself surprised time and time again when I realize that certain things, which I was able to do only yesterday, have become very difficult, if not impossible to perform. Thus, my awareness of "preserving" my abilities is very similar to the healthy person's knowledge that they should stay in shape. Doing something about this, however, is pushed aside by daily routines: work, family, and so on. The problem seems to be worse for people who suffer from muscular atrophy who are in their so-called normal function stage. The fact is that in my case there is presently no standard to determine how much damage physical effort causes, when compared with its preservation function. All the experts seem to agree that movement in water, including swimming, is necessary for the preservation of cardiopulmonary functions. It is also obvious that my daily routine must include resting periods, to relax the damaged muscles and, just as importantly, to loosen up the muscles that have not yet been badly damaged, which compensate for the atrophied muscles.
A busy schedule that includes work, family, rest, hydrotherapy, swimming, massages, meetings with my psychotherapist, leisure time, and meeting my Jahara® therapist - fixed and inflexible activities in my schedule - could wear out anyone, make anyone give up on the activities that require more physical effort, whose timing cannot be altered, or that are unrelated to work. Too often in my life did I sink into the cycle of work-home-leisure, forgetting and neglecting my therapeutic activities.
When the Concept of Support entered my consciousness, it came with an understanding that just as my mind is telling my body how to perform, understanding and accepting my limitations, it is also responsible for the order of priorities assigned to the various activities in my life, all the while knowing that things must be done with attention to details and full awareness. Thus, "life" should not be dictating my daily activities, but I am the one who should determine what is important, distribute my time correctly, and all the while remain aware of the material, physical, and psychological consequences of my decisions. These very qualities are represented by the Metal element in Chinese philosophy. It is the hardest element and it stands for structure, shape, order, and rules, self-discipline, and self-criticism. This element is in charge of stringency, attention to details, perfectionism, and rationalism. It represents order, focusing, self-control, and the ability to act on decisions made.
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