Julia

A case study by David Hall

Julia was in a very difficult position. Her neck and shoulders were distressingly painful and she was unable to relax them, or in fact any other part of her body. If she did relax, disturbing memories surfaced that were impossible to bear. As if dealing with the memories in therapy was not enough, she had a 14 year-old daughter who was suffering from an eating disorder, a nineteen year old who had just done the HSC and a husband with Parkinson's disease as well as a bad back. On top of all this their marriage was about to end. She discovered her husband's condition in 1999, whilst in New Zealand for the funeral of her sister who had just committed suicide.

Julia was diagnosed with Dissociative Identity Disorder that same year having been in therapy since 1992. She found the diagnosis life shattering however over the next few years she found it began to answer many questions about her disrupted life. Julia was admitted to hospital on five occasions for overdoses and then in 2003 a crisis point was reached which lead Julia to admit herself to a private psychiatric hospital interstate that specialised in treating DID. This allowed Julia to get a new perspective on her situation. Following unsuccessful couple counselling after her return she asked her husband to leave the family home. With the help of continuing regular therapy and an indefatigable spirit, she began to get her life back on track.

Regularly she would find respite at a convent. The Nun who ran this convent knew of my work and thought I may be able to help with the neck pain that was currently making her life a misery. She called me in that regard and arranged for me to call Julia. When she first talked to me on the phone and told me of her D.I.D. and it's multiple personalities. She mentioned that frequently a small child appears when she is stressed. She was nervous about how I would react to her condition but I reassured her that all of her was welcome.

Julia had tried physiotherapy, chiropractic, massage, a fitness regime and pain-killers. Nothing seemed to make much difference. She sat there in my room carrying herself as if at any moment there could be a sharp stabbing pain in her neck. However, the realisation that the unnecessary muscular tension in her body may have something to do with her pain, and that she was unable to let it go, came later in the session.

At first I met a small, frightened six-year old who didn't have a name and sat apprehensively in my waiting room. I was taken aback when I first saw her sitting on a chair. Julia is about 160cm tall but she looked at that moment as if my chair was too big for her. She didn't speak to me and just nodded when I bade her welcome and asked her if she wanted to look around first. I left her to look at my rooms on her own then entered and offered her a seat.

We talked a little about our mutual acquaintance Sister Maria, and then I asked her if she had a sore neck. "No, that's Julia" She said. "Oh, that's good, so you don't have to have a sore neck."

"No, that's what Julia has." As she said this, her voice dropped into a deeper register and she began to look taller. I was now speaking to Julia. She held herself with a great deal of tension that was almost certainly contributing to the pain she was suffering. She had her back arched with her shoulders pulled forward. It was as if she was dragging her back around to her front. This posture can create a feeling of having no backbone. It’s as if you are all exposed front - with not enough strength to protect yourself. To release the tension involved is often a great relief.

She told me of her history and I pondered how I was going to be able to help her relax enough to remove the strain without triggering an unwanted reaction. I explained how Feldenkrais and Alexander had experienced problems and been able to resolve them through improving the way they used their bodies. I also posed her dilemma about not being able to relax and spoke of the difficulty this would create when trying to find a way of moving that did not cause neck pain.

She sat there considering her situation. I suggested that she was quite adept at protecting herself from these memories and that perhaps that same skill could be used to find a new way to protect herself, that allowed her to relax.

She agreed that this could be possible and I proceeded with a movement exploration. I asked her to turn her head from side to side within her comfortable range and to notice the difference to each side. It was much easier to turn to the right. I explained that we were not trying to force anything by stretching or straining but merely seeking to understand. To assist this I asked her if she could place her hands on the sides of her neck and continue the gentle turning of her head. I drew her attention to how she could feel through her hands, the way the muscles on each side of her neck were affected and the way her vertebrae turned. She began to relax a little as she listened more closely.

I said to rest and then turn her head once again to each side. To her surprise the comfortable range of the movement had increased and she said her breathing felt easier.

I asked her to place her hands on her neck once again and to resume the turning from side to side, but this time to move her head, chest and arms along with her head. She turned slowly and I asked her where she felt the rotation- the previous time it was in her neck, but where was it this time? In her lower ribs or lower back? The movement began to look more fluid and I brought her attention to the way the front, back and sides of her torso were participating. Her movement slowed once again as she listened more closely and I brought her attention to her breath.

I knew this was a mistake as soon as I said it Her breathing slowed and became blended with the movement. Her attention went inside and then with the subtlety of a change of wind direction she dropped her hands and sat there smiling broadly. It was too much, too soon.

"Hi I'm Mary. I'm seven, and I know everything." Her voice was confident. She sat there swinging her legs and holding onto the sides of the chair. Her face and manner were bright, cheery and responsible. "I come out when the others are a bit scared."

"Hi, it's nice to meet you." I said, "So you help the others?" "I met another little girl earlier. " I said. "Yeah, she's only six- Her name's Ruth. " Mary said "She's a bit sadder than me because she remembers things."

I said, " Well it's great that you can help everyone. " I explained how I had been helping Julia find a safe way to relax and asked if she would like to learn how, so she could tell the others. She enthusiastically agreed, so we returned to the movement exploration. It turned out that Mary didn't have a sore neck, so turning her head caused no problems at all. However, Mary experienced sore forearms, and after a while had to put them down.

I changed the focus of the lesson and asked Mary to gently rotate her arms. We did a couple of variations of this seeking to show her how her arms connected to her torso and neck. I explained how this could be useful to Julia with her sore neck and in the midst of one of Mary's replies, Julia returned. This transformation occurred it seemed, not so much to avoid a dangerous feeling but because it concerned Julia directly.

We spoke a little of her different personalities and how remarkable that the neck or arm pain could disappear so readily. I wondered aloud whether if the personalities cooperated enough to learn this technique all the pains could go.

We continued with the lesson we began with. Julia's neck began to release. We did a variation where she flexed and extended her spine whilst holding her neck and she began to experience pain in her lower back. She was beginning to feel more relaxed now and it seemed that I would be able to use touch without problems. I suggested that I could help her with her pain by tapping on her back, neck and shoulders and she agreed it would be a good idea. She was prepared to take the risk of a stranger’s touch, as she was desperate for any degree of relief from the constant pain.

She sat on a stool whilst I tapped lightly and rhythmically on her shoulders, back and neck. I turned her neck and back side to side before and during the procedure so she could feel the difference. She relaxed significantly and said she felt lighter and generally freer. I used the same procedure to clarify how her arms extend out from her whole head, neck and torso and she reported that her neck pain had significantly diminished.

She had relaxed without the emergence of memories and felt confident to go further. I mentioned that the level of mental organization required to maintain all other personalities was quite striking and that no doubt when she learns to work with them all as one, she would be able to achieve something of great value.

We continued with our theme of rotation, however this time she lay on a low table and moved her knees to each side whilst involving or focussing her attention in different areas of her body. At one point I was rolling Julie's head when Ruth appeared. "What are we doing?" She said. I hadn't actually spoken directly to Ruth since the beginning of the lesson and so I explained what we were doing in a way that was appropriate for a six year old. I explained that when you relax, you can also look for good feelings. She relaxed and Julie reappeared so we continued with the lesson.

After completing one side she lay there being aware of the relaxation. A new personality appeared that didn't have a name. "What am I doing here?" She was relaxed and mature! seemed unburdened. I explained briefly then suggested that she seemed to really understand the process and may be able to help the others.

We continued the lesson on the other side. Julia reappeared for a while. In the relaxation following a variation where Julia could feel the rotation from her pelvis through to her neck, another young personality without a name appeared. She lay there sliding her hands over the table in an excited manner. “ I can feel this,” she said as if she had just discovered it was her birthday. “Can I feel things”? "Yes of course you can." I replied. "Am I allowed to play?" She said. "Yes you can." I replied.

She spoke about the toys in the therapist's room that she had no doubt felt unable to play with and continued exploring the table and her body with her hands. We continued with the lesson and Julia returned. At the end of the session she said she was pain free and was deeply grateful-I gave her an abstract of the two lessons we had explored, and urged her to continue looking for safe ways to relax.

Julie lived several hours away from Sydney and so was not able to return for a while so I wanted to give her enough in this lesson to continue working on her own. She was also in the regular care of a therapist who she referred to throughout our session, so I knew she would have the support to deal with anything that relaxing so much may have brought up.

She e-mailed me a few days later and said that the pain in her neck was much better though her arms were still prone to getting sore. I suggested that she revisit some of the things we had explored in the session and promised her that I would write to her therapist telling her of what we had achieved and that I would be available if she needed more help.

The gentle nature of Feldenkrais and Alexander work may make them extremely useful resources for people who suffer from D.I.D or related challenges. Even though Julia had created multiple personalities, many of who were quite different in age, experience, attitude and attribute, they all shared a common body. Exploring that body in a non-judgemental supportive manner can bring benefit and potential healing for all involved.