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Treatment of a Catatonic Schizophrenic - Initial Stages
Richard Schwartzman, D.O.*
Reprinted from the Journal of Orgonomy, Vol. 15 No. 2
The American College of Orgonomy

John was a 24-year-old, single, white, Protestant man, native of Boston, who came for treatment with the complaint of fear, self-hate, anger and depression. He was desperate and seriously considering suicide. He had been even more severely depressed and immobilized three years previously. At that time, he had dropped out of college because it seemed pointless to him to continue.

This patient presented as a serious and decent young man who had suffered all of his life with deep feelings of misery at the very core of his being. He had never given up, even when feeling his worst, and had continued to work and support himself. It was clear from the start he was not one to complain no matter how desperate he felt. I liked him immediately.

He is the second of three children, with two sisters, one a year older and the other two years younger. His cruel and tyrannical mother never told him he was good or that she was proud of him. No one in the family dared raise their voice to her. The home was a battleground, with the children displacing their pent-up frustrations, anger, and hatred on each other. The mother ruled the children and her passive and alcoholic husband by criticism, ridicule, and humiliation. (John's paternal grandfather had died in a psychiatric hospital after years of institutionalization.) All three children were scarred, but John felt it was his curse alone to be in constant touch with the chronic misery of his life.

John had been a full term child and healthy, but he developed eczema immediately after birth. A post-partum illness in the mother separated him from her for about three weeks, and he was told that he had cried for the first five months of his life; the diagnosis was "colic." He was bottle fed, walked at one year, and was toilet-trained by eighteen months.

His earliest memory, at age 3-1/2, was a feeling of being abandoned, alone, and afraid when his sister went off to day camp. John said of it, "My entire life can be condensed into that sorry scene." He was shy and sensitive, a spectator, peering out into the world, trying to adapt himself to it and be accepted. He excelled academically, but was socially withdrawn, so he read a great deal and watched television. At the age of 14, he began masturbating with sadistic fantasies of forcing sex on a resisting woman. His first sexual intercourse occurred at age 22. He was living at home and working as a computer programmer, a work that made him anxious, especially because he had to deal with people.

Headaches in the occipital and posterior cervical regions had begun at age 5 and had not subsided until late adolescence. Save for the headaches and a predisposition to throat infections, his physical health has been excellent.

Biophysical examination revealed a well-developed, well-proportioned man with good muscle tone. His eyes expressed anxiety and deep panic, and the pupils were moderately dilated. When he looked around the room, his eyes had a jerky motion and doubled back. He simply could not look up and had no idea if he was wrinkling his forehead up or down. He kept his eyes half closed, as if expecting to be attacked. His posterior cervical muscles were rock-hard, and his jaw could be moved only with some resistance to the motion, even though he tried to let it hang slack. He could shout loudly with a harsh, raspy voice. When he breathed, his chest moved little. The posterior thoracic musculature was firm and hard, and the anterior sensitive. He hit with short choppy strokes. The diaphragmatic and abdominal segments were tense, and the pelvis could be moved against moderate resistance. His legs were stiff, and he could barely kick. My diagnosis was catatonic schizophrenia.

To date, he has had a total of 158 sessions. In the first three sessions, I manually compressed his chest, while forcing him to keep his eyes open and in contact. This mobilization relieved some of his acute depression, and we both breathed easier. From that point on, each session has been very much the same: A few deep breaths cause him to feel terror, and he contracts and stiffens. His eyes almost close, with pupils fixed and moderately dilated. His arms are pulled to his sides and the legs are together and drawn up slightly. He shouts out in a loud rasping voice.

It wasn't until the 9th session that his terror began to be understood by both of us. He visualized a form, possibly a man, when I forced him to look up and to the left. This began the process of frequently re-experiencing the specific horrors of his childhood. He has seen clearly his father and mother coming at him: his father with a demonic expression and sometimes with a knife (age 4), his mother intending to hurt him. He cries out, "Please, don't hurt me!" He has relived being smothered with a pillow, held under water, and choked. He always feels worthless and bad, and sometimes hears his mother's voice cursing him within his own head or coming from the walls of the room.

He could not move his arms until the 18th session, and then only to bring them up to protect his face from blows. In the 22nd session, he was able to move his legs and relieve some of the spasticity in his upper segments. He still cannot kick. He could not follow my finger or a light at all with his eyes until he could move his legs. By the 26th session, he was able to raise his eyebrows and forehead to intensify the fear and open his eyes while he shouted. By the 50th session, he was able to sustain some rage, to hit the couch, without contracting in fear. In the 68th session, the loneliness and longing that had been admixed with other feelings was felt, and he was able to cry with tears.

Direct work on the armor has been confined almost exclusively to the head, neck, and legs. Sometimes, I work vigorously on the scalp muscles and, at other tines, have him move his scalp slightly against my resistance. Another technique is to hold his jaw down and press on the masseters, while I squeeze the posterior cervical muscles and have him shout. I no longer must constantly hold his eyelids open to keep in contact, and he can now sustain breathing for twenty minutes. All other direct biophysical work has been directed to the trapezii muscles and the legs. Because he can't yet kick well, he walks about the treatment room at the end of each session to overcome the contractions in his legs and regain composure.

There has been little character analysis per se. Support, encouragement, and understanding are vital in each session. He often feels he'll never get better. He procrastinates to avoid breathing, especially now that the terrible loneliness and longing are surfacing. He recently dreamed he was on a tightrope, unable to go back and yet afraid to move forward. He lives with constant anxiety but continues to function in spite of it. He is feeling more than ever and gaining inner strength that wasn't there previously. He has married, is renovating his new home, and is a self-employed carpenter. Without his wife's support and understanding, he would never have come so far.

John shows extraordinary courage, drive, and determination to get well in the face of a severe illness. Neither of us knows how far he can go, but he has made a good beginning.

* Medical Orgonomist. Diplomate of the American Board of Psychiatry and Neurology. Asst. Professor, Department of Mental Health Sciences, Hahnemann Medical College and Hospital of Philadelphia. Inpatient Medical Director, Hahnemann Mental Health Sciences Division, Philadelphia Prisons.

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