Relaxation Tape

As part of our curriculum we had to record a relaxation tape so I decided to include in my blog because I tried it out on a client and it was really effective ... Enjoy!

Be the change you want to see in the world

Archbishop Desmond Tutu has had a series of recent outbursts slamming the current state of affairs in our country and in my opinion his concerns are completely valid.  “What on earth are you doing!” he shouted in reference to violence that is currently plaguing our country. I can only agree! For years individuals like Nelson Mandela fought for peace and equality in South Africa but we seem to have completely disregarded their intent for our country. We are killing each other and in doing so we are killing the vision that Mandela and other notable freedom fighters had for South Africa.

This is an issue that I feel particularly strongly about. I love my country. It is rich with diversity and culture and there is beauty everywhere we turn, but I live in fear. I live in fear for myself and the people I love.

“The greatest gift our nation could possibly give uTata Nelson Mandela … would be to emulate his magnanimity and grace" Tutu said during Mandela’s 94^th birthday celebrations. This reminds me of my favourite saying by Gandhi which is “be the change you want to see in the world.” This is so appropriate to our current state of affairs. It is up to us to make a change.  If we as South Africans can lead by example and be ambassadors of a country that Mandela and the other prominent freedom fighters envisioned for our country we would live in a more united and peaceful place.

“I am 80-years-old. Can’t you allow us elders to go to our graves with a smile, knowing that this is a good country? Because truly - it is a good country!” Tutu said. I suggest we work together as a country to make Archbishop Desmond Tutu’s wish come true.

A Tabelspoon of Inspiration

Joost van der Westhuizen is widely known for his successful rugby career, his marriage to Amor Vittone, and the infamous sex tape. He even admits to be arrogant saying “I must say I was a bit arrogant. But that’s what my life of playing rugby made me. I am not blaming rugby at all. It is a question of everybody wants your autograph, your photo, your time… all your life, people looked after you. You got away with everything.”

Admittedly, from this, I drew up a rather unflattering picture of this man in my mind. However, after watching Derek Watts’ interview with Joost on Carte Blanche the picture I had developed of him slowly changed and he became an inspiring role model to anyone battling disability.

These days Joost is more commonly recognised for his battle with amyotrophic lateral sclerosis, a motor neuron disease that is rapidly progressive and characterised by muscle weakness and wasting. In Joosts case this has resulted in slurred speech, clumsy fingers and a weak grip. His doctors have given him 2 to 5 years to live.

Now Joost is a changed man and spends his time and money supporting others with similar disabilities through his charity the J9 foundation and rather than taking the credit for his actions he insists that at public fundraising events his publicist talk because he does not want the event to be about him.

His battle to perform the simplest of tasks was heart breaking to watch but Joost points out “I am still alive, not dead.” He told Watts that “there was a time in the beginning when I just withdrew. And I actually had to make a decision: I’m going to sit here and die or you’re going to live your life, enjoy it while you can. And I wake up with a smile.”

This is so true to any one battling disability or adversity. Every moment you are alive you make a conscious decision to feel happy or sad, positive or negative, helpless or powerful, victimised or motivated. It is up to you to choose how to feel every second of every day regardless of situation or circumstance.

Choose wisely.

Visit to St Thomas Children’s Home

Some information on St Thomas Children’s Home

“St Thomas’ Children’s Home is a registered non-governmental organization located in Sherwood, Durban. They have 60 children that reside at the home between the ages of 2-10 years old. The children come from disadvantaged backgrounds, that is, HIV positive, abandoned and orphaned, abused and neglected. They are committed to provide holistic programmes to enhance the quality of life of their children. They facilitate the re-integration of children into the community of families.” (Rotary District. 2012)

Our trip to St Thomas

On Saturday our class was privileged enough to visit St Thomas Children’s Home. We were divided into groups and asked to plan activities for the children. Our group had to plan an activity for the Daisy’s which were boys and girls between the ages of 5 and 6. As a warm up we commenced the session with a game based on the premise of pass-the-parcel. Music is played and a ball is passed around the circle. Whoever is holding the ball when the music stops has to perform a task given to them by a student in order to win a prize. The tasks centered on teaching the children fundamental concepts like colours and numbers. For example, a student would hold up a blue card and ask “what colour is this?” or the student would hold up a shape and ask “what shape is this?” The students ensured that each child got to participate and received a prize.

The main activity was shakers making. The shakers were made using toilet rolls and a variety of beans and grains. The children made the shakers and were encouraged to decorate them.  Once all the children had made a shaker the students and the children sang nursery rhymes which gave the children an opportunity to use their shakers.

Overall, the activity was a huge success as the children really engaged with the students and had a good time. I felt like we provided a fun element and was successful in breaking an institutionalized regime. However, the session could have been planned better to reduce the confusion among the students and children. Additionally, there were too many students giving instructions which further confused the children. I would suggest that one student be put in charge and the others assist when needed.

As much as I loved spending time with the children it was hard to accept that we only popped in for one morning and then we returned to our privileged lives with families that care for us while these children would remain in the home. It made me grateful for everything that I have but also bad that I wasn’t doing more.

Valuable resources for dealing with vulnerable children:

http://www.vfpms.org.au/childrenatrisk/vuln.htm

This website aims to teach health professionals about vulnerable children and how to recognize them as well as our role in dealing with vulnerable children. It is very comprehensive and resourceful.

References:

Rotary District. 2012. St Thomas Children’s Home. [O]. Available: http://www.rotary9270.org.za/westville/projects/41/ Accessed: 30 July 2012

Values Clarification

Today we had a lecture on values clarification. Sounds interesting? Well, it was! I have never taken the time to think about what my values are in life even though our values are the crux of who we are.

The lecturer began by asking us to plot on a scale our feelings about homosexuality and abortion. Two topics surrounded by controversy and guaranteed to spark debate. Before even entering into the debate people where nervously placing their dots on the scale for fear of being judged. The debate continued for ages with compelling arguments for and against each issue. The discussion got heated as people could not understand why others did not think the way they did. Of course, this is the fundamental issue. Our values determine what we believe in and personal values are so deeply rooted and ingrained that they will not or very seldom change.

What I learnt is that it is important to know your own individual values because they provide a strong sense of self and; as one our class members so beautifully put it: “if you don’t stand for something, you’ll fall for anything. However, having said this, we need to accept that human beings are all unique and, consequently, so are their values. This is a valuable lesson to take with us into treatment which brings me back to the growth games publication - like I mentioned it is so important to leave your values “at the door” when treating a client because, in order for treatment to be successful we, as Occupational therapists, have to be completely accepting of our patients and not impose our values on them. It is not up to us to change other people’s values in fact the world would be a much happier place if we could all agree to disagree!

Another, less controversial way of addressing values clarification with your client is to do an exercise where you list actual and ideal values; find the gaps between them; and decide on a plan of action to accomplish your desired values.  This is a lot harder said than done. One has to be very attuned to and honest with yourself but if this is possible it can be a very successful exercise.

Values clarification is not an issue that should be overlooked in treatment. It is essential to a holistic and successful treatment plan. Not only is it valuable for the client to clarify their values but it is essential for the therapist to know her values so that they do not get in the way of a successful treatment.

Just the Motivation I Needed ...

Today, our class was lucky enough to be visited by a very motivational man. He is a service user at Newlands Park Drug and Alcohol Rehabilitation Centre in Durban. He was admitted to Newlands due to his addiction to drugs and he is currently nearing the end his stay there. This was his first time speaking to people about his condition and he was open and honest in his delivery. I admired the way he stood up in front of a group of people he didn’t know and shared his story.

I should probably mention that at this point I am not feeling as motivated and passionate about Occupational Therapy as I have always been (Apparently, a completely common phenomenon for an OT student). I am struggling with the work and am demotivated by the lack of progression in my clients. However, after listening to the massive change that one (very small) Occupational Therapist made in this man’s life my spirits were lifted. He was a reminder of why I started studying Occupational Therapy in the first place.

More important though, were the valuable life lessons that I learnt from this man’s talk.  The first lesson is we are all responsible for our lives or as he put it “our life is in our hands.” It is up to us to set goals and make the appropriate changes to achieve those goals. The second lesson is believe in yourself. He says it is important not too care too much about what people think. A skill I could definitely apply to my life. He says “if people don’t like me, it is okay, because I like me!” Food for thought indeed! I only hope that I can take a leaf from his book and apply these valuable lessons to my own life.

Growth Games

Today we were taught about growth games which are described by our lecturer as “games” that “nudge a person to awareness” in other words “through the experience of an activity” individuals become aware of “emotions, potential or issues that challenge them at some level.”

Our lecture began with a growth game that explores the issue of personal values. Our class had to pretend that we were on a sinking ship that only had one life raft. The game required us to choose a select few to take the limited spots in the life raft and motivate why we choose them.  The aim of the game was to put the participants in “survival mode” thus encouraging our fundamental values to shine through.

Playing the game was much harder than it sounds because we weren’t really in a panic situation so in reality we were all being cautious not to offend anyone. However, the exercise was successful in forcing us to explore our own individual as well as common societal values. For example, many people were passive and elected to stay on the ship. This could indicate that these individuals value being a good person and possibly even a martyr. In my opinion, this is not surprising for people that have elected to do a caring profession like Occupational Therapy. The game also raised questions like: why does society believe that, in the case of a sinking ship, men should stay back and women and children should automatically be given a place on the raft?

The most important lesson I learnt from this game was that individual values vary so vastly. Now, I know this sounds obvious but I think occasionally we forget this and we either force our values upon other people or we judge people for their values. This is an important lesson to take into treatment - as therapists it is important to accept different individual’s values and not impose our values on others. It is not our job to judge it is our job to ensure people live meaningful lives that are concurrent with their values.

The fact that these observations were made and these particular questions were raised is proof that the exercise was effective in getting the juices flowing and thinking critically about why we chose certain individuals; therefore making growth games an essential and effective tool that every OT should be able to pull out of their bag of tricks.

A Beautiful Mind

As part of our Psychopathology curriculum we had to find a movie that dealt with mental illness and using the DSM-IV-TR diagnose the condition. Below is my assignment on A Beautiful Mind, a movie about a man living with Paranoid Schizophrenia.

“A Beautiful Mind”

The movie, A Beautiful Mind, is loosely based on the life of John Nash, a Nobel Prize winning mathematician living with Paranoid Schizophrenia. The movie provides an informative case study of a person living with the condition. The essay attempts to analyse John Nash and verify his diagnosis by highlighting the characteristic symptoms of paranoid schizophrenia, using the criteria provided in DSM IV TR.

According to the DSM IV TR social dysfunction is a criteria of Schizophrenia and from the beginning of the movie, it is evident that John Nash’s social skills are poor and it is difficult for him to make and sustain meaningful relationships. The first impression of Nash is that he is awkward and withdrawn. This is illustrated when Nash says to a peer “there is a mathematical explanation for how bad your tie is.” Considering Nash did not know this individual, the comment is insulting and inappropriate. To further highlight this point John states “I don’t like people much and they don’t much like me” and later in the movie he refers to himself as a “lone wolf” due to the fact that he has “no family and no close friends.” These statements indicates his battle to create meaningful interpersonal relationships.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

Another good example of Nash’s poor social skills is shown in his interaction with girls. Early in the movie he says to a girl, who is obviously interested in him, “I don’t know exactly what I’m required to say in order for you to have intercourse with me but could we assume I said all that? I mean, essentially we’re talking about fluid exchange right? So could we just go straight to the sex?” This statement is a perfect example of Nash’s disregard for social norms which is what inevitably affects his ability to form relationships.

When, on a second date with his girlfriend Alicia, he says “polishing my interactions in order to make them social requires a tremendous effort. I have a tendency to extradite information by being direct and I often don’t get a pleasant result.” He further goes on to say “I find you attractive. Your aggressive moves toward me indicate that you feel the same way, but still, ritual requires we continue with a number of platonic activities before we have sex. I am proceeding with those activities but, in point of actual fact, all I want to do is have intercourse with you as soon as possible.” This, again, illustrates his poor social skills which affect his ability to create or maintain meaningful relationships and consequently results in social dysfunction. However, while he disregards social norms he acknowledges that his social skills are not in keeping with societal norms and accepts that. This is evident when he says ‘I don’t often get a pleasant result” and “are you going to slap me now?”

Paranoid Schizophrenia is characterized by a preoccupation with one or more delusion and it is only toward the end of the movie that the audience is able to distinguish Nash’s paranoid delusions from reality.

Looking back, the first sign of paranoid delusions comes when Nash has to decipher a code for the United States Army. He sees a man watching him and says “who is big brother.” The delusions seem to snowball from this point and eventually he is introduced to William Parcher, who works for the Department of defense. Parcher explains that The Russians stole an atomic bomb from the United States, which has the potential to kill millions, and they plan to detonate it “on United States soil.” Parcher further explains that a branch of the Russian army, called New Freedom, has agents in the country and that they communicate to their agents “through codes embedded in magazines. Parcher propositions Nash to use his code-breaking skills to find the hidden messages in magazine articles.

Gradually, Nash becomes increasingly nervous and suspicious. For example, on his first date with Alicia he believes two men are watching him and at his wedding he sees Parcher keeping an eye on him.

Nash becomes preoccupied with the delusions to the point that they control his life and interfere with his personal relationships. For example, when he arrives late to meet Alicia for dinner on her birthday, he says “I’m sorry I’m late. I got caught up at work … again.” Again, this is evidence of his preoccupation with a delusion which results in social dysfunction, both of which are criteria of schizophrenia, according to the DSM IV TR.

 In addition, his appearance becomes increasingly more disheveled which indicates that his preoccupation with the paranoid delusion leaves him little time to take care of himself. According to DSM IV TR self-care is “markedly below the level achieved prior to the onset” of the condition, in individuals with schizophrenia.

After his marriage to Alicia he becomes more distant and spends more and more time decoding articles for the government. His behavior becomes erratic as he becomes more suspicious and paranoid.  One evening he comes home, scared after speaking to Parcher, and proceeds to lock Alicia out of his room while she screams “talk to me!” Another example of how the delusion that has resulted from his condition are affecting his relationships.

His paranoia and suspiciousness also become evident in his behavior and mannerisms and there is a noticeable departure from his usual self. For example, Nash walks around with his brief case very close to his chest as if it contains valuable top secret documents. In addition, he walks into a lecture, still holding his brief case close to him, looks suspiciously out the window and, thinking he sees Russian spy’s, rushes out of the lecture venue. Again, this is evidence of his preoccupation with the delusion, the result of which is social and occupational dysfunction, which is characteristic of an individual with schizophrenia, according to DSM IV TR.

Nash’s paranoia increases when Parcher threatens to put Nash and his family’s lives in danger if he quits working for the government, by letting the Russians knows that he works for them. Nash sits in the dark watching for Russian spy’s and gets aggressive with Alicia when she turns on the light. Later, he says to Herman, another delusion, “I’ve got myself involved in something that I can’t get out of.” This highlights his preoccupation with the delusion.

Eventually, Alicia, who is very worried about her husband, commits him to the hospital but when the psychiatrist comes to take him to the hospital he punches him and shouts to Herman “I know who they are!” “They’re Russians!” The fear that stems from the paranoid delusions controls his life. This persists in hospital which is clear when he says to Alicia “we have to talk quietly. They may be listening. There may be microphones.” It is also evident when he scratches himself until he bleeds to try and find a chip implanted in him by the United States government.

These symptoms continued for years and according to the DSM IV TR in order to be diagnosed with Schizophrenia signs of disturbance must be persistent for at least 6 months which means Nash meets this criteria.

John Nash is a brilliant mathematician living with paranoid schizophrenia. The movie, A Beautiful Mind, portrays Nash’s battle with the condition. Nash suffered from hallucinations and was preoccupied with a delusion which impacted his ability to create and maintain meaningful relationships, work or take care of himself. These symptoms all lasted for longer than six months. According to the DSM IV TR these are all criteria for paranoid schizophrenia and thus he has been accurately diagnosed with the condition.

Introduction

I am currently a 3^rd year Occupational Therapy (OT) student at the University of KwaZulu Natal in Durban, South Africa. As part of our curriculum we were asked to start a blog. This blog can be best described as eclectic. There is no theme, rather is it a compilation of my thoughts and experiences as an Occupational Therapy student.

What is Occupational therapy?

“I am studying Occupational Therapy” is what I tell people that ask me what I do, to which they usually respond “Oh! You work with children that have learning disabilities” or one more memorable response was “Wow! That must be really hard because there are so many occupations.” In that particular instance I nodded in agreement because I could tell that it would be harder to explain further, but my personal interpretation of Occupational Therapy is we treat both mentally and physically disabled individuals and our aim is to help them lead independent and meaningful lives. This is by no means a text book definition but personally I think it sums up what we as Occupational Therapist to achieve which is to give people meaning. This is the aspect of our profession that makes me love what I do.

I hope you enjoy reading this blog as much as I enjoy writing it …