Tying Things Together

Tying Things Together Pt 2

Did you watch the clips of the real life Helen Keller and the dramatised version? You’ll have noted Helen’s learning through touch. In fact the clip with the water pump underlines this by showing her throwing away the pale to feel the wet stuff flowing. Only then can she make the connection. It’s also obvious to us that it’s her frustration with herself and/or loss of patience with her teacher, Anne (most likely a bit of both) that throws the pale away.

All emotions serve their purpose.

Let’s look some more at Cognitive Rehabilitation Therapy.

Part 2: Development

CRT is a coming together of four professions. Let’s treat them as threads – look at them separately, then see how they’re knotted.

(Neuropsychology)

This is the study of how different areas of the brain work to make us do what we do, learn what we learn, know what we know, share what we share.  The grand-daddy of this science is Alexander Luria. (Click on his name if you want to know more about him.)

(Physiotherapy)

Most of us understand this. Exercises for the body – having limbs and muscles yanked about for us and/or stretching, bending, lifting and moving our bits as much as we can by ourselves. How does this help rehabilitate our brains? Well, take my brain, for example.

I have a daily routine of eight exercises I try to stick to help improve the thickness of my right leg. (If I do them every day from Sunday to Saturday without fail I reward myself with a flapjack and a beer. I especially enjoy them as I watch the latest crime thriller on BBC4.)

Anyway, my point is: co-ordination. For me, it’s not a matter of automatically stretching the tendons behind my right knee. Oh no. I have to think about how my left leg straightens so I can tell my right leg to have a go at matching it. So far, this means telling my right knee to pay attention to where my right heel and my right hip are, so it then learns for itself where it is and tells me if it’s ready to play along. To persuade my right knee,  I get my head to kind of speak kindly to it. If it is happy to listen, it allows the back of itself to get closer to the floor.

In this way my brain and right leg are teaching each other.

(Occupational Therapy)

Occupational Therapy is more than physiotherapy. It specialises in the physical, environmental and social needs of the individual. This way of looking after patients actually has its beginnings in the 1700s and what was called “The Moral Treatment Movement”.

To learn more about it and the advancement of OT, click here.

These days some Occupational Therapists are interested in how specific occupations benefit communities too, not just individuals. They look at what we are most happy doing, how and where we can do it, and who else we make happy by doing it.

(Psychotherapy / Counselling)

The treatment of troubled, injured or disabled minds by talking, has a long history. Sigmund Freud looms large in both neuropsychology and psychotherapy. (Click his name if you want to know more.)

What’s the difference between psychotherapy and counselling?

To my mind the two are so closely entwined, like the two threaded twist in DNA, it’s hardly worth asking.  When the trained professional employs congruence, empathy, unconditional positive regard and listens, (s)he is a counsellor. When (s)he considers what they’re hearing and the suitability of an intervention or coping strategy, and suggests it, (s)he is a psychotherapist.

So, there we go – the four professions that interweave and knit together into this thing called Cognitive Rehabilitation Therapy.

How?

  1. Luria and Freud often corresponded, sharing their ideas and inspirations regarding how brain sections, personality and society are linked. In this way they tied neuropsychology and psychotherapy together. Changes to the brain = changes to the person. So, talking to the person = talking to the brain.
  2. Physiotherapy is, effectively, body-talk. People talk about the brain and body as though they’re separate, or at least revere the brain as if it’s somehow superior to our other organs. This IS NOT the case! Yes, our brains influence our movement, muscle tone and general physique and give us a sense of “being behind our eyes”. But here is the bigger truth: All body parts together, brain included, depend on each other.
  3. Occupational Therapy, puts 1 and 2 together. Like psychotherapasists, occupational therapists treat the whole person because thinking, doing and emotional wellbeing depend on each other.

Enough for now. Next month we’ll see how Cognitive Rehabilitation Therapy is practiced. Take care one and all.

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