A psychophysical approach to treating schizophrenia

In my memoir, The Scenic Route: A Way through Madness (coming out in the New Year), I devote part of a chapter to The Alexander Technique. In researching the technique, I came across the name of Kitty Merrick Wielopolska who was a student of the technique in the 1930s. I haven’t read her book, but it seems that it would be well worth adding to a collection of schizophrenia memoirs that have credited healing to a non-mainstream approach. In this interview, I also learned for the first time about a relatively recent psychotherapy (phenomenological psychotherapy) which my experience tells me shows great promise in breaking the habitual patterns of thought that Alexander termed a “misuse of the self.”

Never Ask Why

THE LIFE ADVENTURE OF KITTY WIELOPOLSKA (1900-1988)
Her experience with the Alexander Work, schizophrenia and the psychic state

Published by Novis Publications, January, 2002. www.novis.dk

(NOVIS is a small publishing company specializing in publishing literature on the Alexander Technique)

The following is from Joe Armstrong’s interview with Kitty that was published in 2001 several years after her death

From the moment I met Kitty (Catharine Merrick) Wielopolska in 1966 – over ten years before we began recording these stirring conversations about her struggle with schizophrenia 1  – I felt she was an extraordinary person. But after hearing for the first time in these talks about her many breakdowns and the inspiration for getting herself well that she found in the Alexander Work, 2  I realized that there were many more reasons why she was so very remarkable than I could ever have imagined.
While these conversations don’t claim that Kitty used the Alexander Work itself as a direct means to her recovery, 3  I believe they do show that her intensive experience of it had a substantial indirect influence on her ability to find her way to health. This is because the Alexander Work is based on the conception that it is impossible to separate “mental” and “physical” processes in any form of human activity, and it would therefore require us to regard a condition like schizophrenia not just as a “mental disorder.” It would also require us to take into account the “use” of the whole person when diagnosing the disorder and searching for ways to treat it. “Use,” in Alexander terminology, refers to our combined manners of responding, moving, and thinking as they are manifested in our overall behavior at any given moment, whether the behavior is governed subconsciously by our habits or is consciously guided by our chosen intention.

With that in mind, it’s very interesting to read that at least one branch of psychiatry has recently been taking a psychophysical approach to schizophrenia and is focusing on the same area of concern that F.M. Alexander found to be central in re-educating the use of ourselves as a whole. Phenomenological psychiatrists such as Shaun Gallagher are considering the possibility that the “voices” heard by people diagnosed as schizophrenic stem essentially from a breakdown in what he calls our “protentional function.” This governs our ability to “anticipate experience which is just about to happen,” in contrast to our “retentional function,” which governs how we “retain previous phases of consciousness and their intentional content.” Gallagher also says that our sense of “agency” in both motor action and cognition “depends upon the protentional function for its proper registration at the level of consciousness.” In other words, he attributes to the working of our protentional function our judgment about whether or not it is actually we who are doing our actions and thinking our thoughts – a judgment the schizophrenic often has great trouble with. 4

In traditional Alexander lessons and in the very intensive Alexander teacher training, both of which Kitty went through, 5 a great emphasis is placed on becoming aware of what happens simultaneously in our thinking and our musculature at the critical moment when we form an expectation of what is going to happen next. By learning to inhibit the subconscious, habitual thinking that Alexander referred to as our “preconceived idea” (which often produces a muscular set in expectation of an action), and by replacing it with a directed thinking which coincides with an integrated working of our postural mechanisms conveyed to us by the Alexander teacher’s hands, we can allow the teacher to guide us through an action that is free from our habitual expectational influences and is therefore more available to be infused with an improved integration of the self as a whole. Eventually we can use this improved psychophysical unity, when we are on our own, to make ourselves as effective as possible in keeping our expectations from influencing our actions and thoughts in a disruptive way. (The American philosopher and educationist John Dewey, who studied with Alexander for many years, called this form of constructive conscious control “thinking-in-activity.”)

Practicing this “non-endgaining” discipline every day in a three-year teacher training course, guided by the hands of skilled teachers, can bring a person to a level of psychophysical integration that is inconceivable even to an experienced Alexander pupil having weekly individual lessons. For most people who have undergone the full teacher training, the new, integrated way of thinking and responding gradually becomes an intrinsic part of their existence, a part of what Alexander called their “reaction to the stimulus of living.” Even in the face of extreme duress or debility, many Alexander teachers find that at least some degree of the integration remains operative in them – as I believe it must have been for Kitty during her most traumatic times.

If the phenomenological psychiatrists’ view of the key role of the protentional function in schizophrenia proves to be accurate, it might shed more light on the place of the Alexander experience in Kitty’s unusual self-recovery. Before her first breakdown in 1931 she had already been introduced to Alexander’s process of dealing with this anticipatory phase of activity; and she went on during the next three years of her first remission to work even more extensively on developing conscious control in that realm while she attended Alexander’s teacher training course. She continued with this self-discipline the rest of her life, during her remissions as well as after the point in 1967 that she describes here when she felt she was permanently well. And even though she had an additional, brief breakdown after we completed these talks – in 1980, when her brother died – she managed to deal with it at home by herself without medication and resumed her teaching a few weeks later. By that time she had over fifty years’ experience of the Alexander Work, including the two intensive, full-time, three-year training periods and ten years of teaching others, which itself is based on the teacher’s constant attention to his or her own psychophysical integration. So it seems very likely that her Alexander experience could have given her a means of gaining access to this protentional function, a means unavailable to most others with her condition.

Phenomenological psychiatry also sees our sense of ownership of our thoughts as based on the retentional function; and, in the schizophrenic, it sees having at least some of this sense of ownership as an important and positive sign. “When a schizophrenic reports that certain thoughts are not his thoughts,” says Gallagher, “he is also indicating that these thoughts are being manifested not ‘over there’ in someone else’s head, but within his own stream of consciousness. His complaint is not that he is suddenly telepathic, but that someone else has invaded his own mind. The sense of ownership is still intact.” 6 Kitty’s description here of how she resolved the element of “hearing voices” – by deciding to attribute them to a psychic source outside herself – seems to conflict with this idea of the importance of ownership. But I think her resolution shows that she had acquired a valuable form of conscious control through her intensive Alexander experience, and therefore a stronger sense of who she was and a greater ability to deal with any thoughts external to her sense of self. And the issue of whether or not psychiatry would accept that kind of resolution as a valid recovery seems insignificant in comparison to the triumph Kitty ultimately achieved, which allowed her to lead an enormously productive and gratifying life during her last twenty years, even numbering among her many admiring Alexander pupils some of Philadelphia’s prominent psychiatrists.

When I suggested to Kitty in the middle seventies that we try to do this “interviewing” in case it might be valuable to the history of the Alexander Work and of interest to clinical psychologists and psychiatrists, I think we both sensed that it could lead into some uncharted territory for her. And as we went on talking and recording, often in stints of several days or weeks at a time in Boston, at White Mountain inns, or at her family’s villa in Tuscany, it did seem as if somehow a subtle burden was gradually being lifted from her shoulders, and each morning she would come to breakfast looking more refreshed and radiant.

Over the years since Kitty died, I’ve learned more about how valuable it can be to have the chance to tell our life stories to someone who listens and questions in just the right way, allowing us to go into them fully and richly. So I feel grateful not only that these dialogues will survive to give others any inspiration, insight and hope they might contain, but also to have had an opportunity to help Kitty tell her story in a way that might have added more meaning and richness to her later years.

Once Kitty and I felt we had recorded everything about the topics and events we wanted to cover, we spent a great deal of time going over the transcript together. I took responsibility for arranging the sequence of chapters, selecting their titles, and providing footnotes; and I also suggested we alter some of the sentence order for the sake of clarity. Kitty told me that her husband, Count Wielopolski, had once said that she was “like a grasshopper” because she so often jumped backwards in telling a story. So even though I’ve turned some of the jumps around, I hope the liveliness of her speech is still preserved, because it was so wonderful to hear her talk, to hear her laugh, and to laugh with her.

One of the last times Kitty visited me in Boston, she came across a passage in David McCord’s book About Boston 7 that touched her deeply. She started to read it aloud to me, but when she came to these lines by Samuel Eliot Morison she was so moved that she had to ask me to finish reading them. I think they characterize well the spirit of this whole memoir, and calling up the poignancy of that moment is a fitting tribute here, just passing the centenary of Kitty’s birth:

“. . . in that unknown harbor toward which we all are scudding may our eyes behold some vision like that vouchsafed our fathers, when a California clipper ship made port after a voyage around the world.”

Footnotes

1. “Schizophrenia” is the term Kitty and her doctors originally used to define her condition. After we finished these talks, Kitty told me that several psychologists and psychiatrists who were her Alexander pupils had said that they didn’t believe she could have been schizophrenic, considering how they perceived her during their encounters with her. But they did not know her during the intense periods of illness that she describes here, nor had they read of all she had gone through; so I have decided to leave the word “schizophrenia” in place. It would be very interesting to know how any experts who might read this book would categorize her condition now.

2. See “An Introductory Note on the Alexander Work,” p.

3. It was suggested recently (May, 2001) by one psychiatrist who read this manuscript that, since recovery from schizophrenia is extremely rare, it would be valuable to include records of Kitty’s actual diagnosis, date of recovery, etc. But I decided against making any search for such records because I felt it somehow would be a betrayal of Kitty’s trust if I did so without her direct permission. Because of her own early career as a nurse, I’m certain that she would have agreed to publish any documentation that might lend credence to the book in the eyes of the medical profession; however, I hope that letting it rest merely as a personal memoir will not deter experts from seeking that information themselves if it would help them in considering her case more completely.

4. See “Self-Reference and Schizophrenia,” a collection of papers presented at a conference on advances in consciousness research held at the University of Copenhagen in May, 1999, entitled Exploring The Self: Philosophical and Psychopathological Perspectives on Self-Experience. Amsterdam/Philadelphia: John Benjamins Publishing Company, 2000, p. 233 & 230.

5. Kitty attended Alexander’s first teacher training course in the 1930’s and then later retrained with Patrick MacDonald from 1969 to 1972, when I was also going through the training with Walter Carrington. Both Patrick MacDonald and Walter Carrington trained with Alexander himself.

6. Exploring the Self, p. 231.

7. See David McCord, About Boston; Boston: Little, Brown & Co., 1948, p. 68.

JOE ARMSTRONG
BOSTON, 2001
http://www.joearmstrong.info