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Working With Maribel - A Case Study by Danny Burke

     I never thought I'd have a client quite like Maribel. I first started working with her when she was 91 years old. We originally did four Hanna Somatics sessions, but then we we did no sessions over the next couple of months. We then did four more sessions together. She could only do somatic homework movements while lying in her bed. But she didn't seem to be able to remember these specific homework movements, let alone how to do them somatically. Maribel’s biggest issue was discomfort and pain throughout her body. She displayed the posture Thomas Hanna described as The Dark Vise, with a significant curve toward one side.

     Her grandson, who lived with her and looked after her, provided me with the best feedback. He told me that she improved so much after each session and had much better posture and a lot less pain. She was able to do her morning walks much more easily. The main problem, he told me, was that she wasn’t able to "remember" the pain relief she gets from the somatics sessions. Even though she has gotten a lot better, Maribel doesn't seem to be aware of it.

     After these first somatic experiences, almost a year passed without any further sessions. Then Maribel suffered a stroke, and was not expected to survive. But her strong will to live seemed to keep her going, and she did recover. The stroke affected her entire left side. After she left the hospital, she was no longer able to walk, she had a frozen left shoulder, her left arm wasn’t able to move, the left hip was very stiff and the left leg was limp along with a left foot-drop.

     The family chose 24 hour home care, with several nurses on rotating shifts. Physicians, physical therapists, and occupational therapists made home visits whenever needed. After a few months, the family decided to bring me back in to restart a Somatics plan with Maribel. The first session was really an eye opener for me. I have to admit, I really wondered how in the world I was going to help her.

>> Many of the muscles throughout her body were rigid: her left arm seemed to press into the left side of her rib cage. A red light reflex tugged her sharply forward. Yet the stroke seemed to have one positive effect, since she no longer suffered from pain on the level she had before. But Maribel could no longer walk, or use the bathroom on her own, so she consequently lost her independence. Still, she maintained a great attitude, and was always up to do as much as I asked from her. I decided to start with what still moved easily. Even though she had some cognitive impairment and wasn't always sure where she was nor what year it was, the work we did together always seemed to have a positive effect. I was able to work with her one hour, twice a week.

     Here are some of the decisions I made, and the things I learned, working with Maribel. I decided to dispense with my table and simply work with her on her hospital bed. This proved to be much harder on my back, since I had to lean in further, sometimes at awkward angles. Nonetheless, she had developed various medical conditions that made using a table both impractical and unadvisable. The nurses showed me how to safely turn her onto her sides and back, so eventually we could do more moves from different positions. I learned to listen for her mood and to consider the state of her soma each time I came in, to determine just how we’d approach her somatic work for that day. I tried to keep her focused on sensing and feeling all the things she could as we did our somatic work. I convinced her that her ability to feel things inside her body was her "super power" and she became quite good at providing feedback for me as to how each move felt. I gradually discovered when she needed means whereby, kinetic mirroring and pandiculation, right alongside her, as she was able to explore how much she could still do.

     We laughed together, as I figured out a few topics that always brightened her day. I told her that a session is never really complete until I see her smile. Sometimes she would weep, when her soma required it, and I’d discover the "secret" means whereby movement that could instantly provide her the most comfort. We had fun together whenever we “did the hokey pokey” from a children's video on my mobile phone. And so the months went by; the years went by...

     Some things baffled me. After every session, I would leave her very relaxed, even on her left so-called “paralyzed" side. I had discovered early on that she actually had some movement whenever I encouraged her to attempt to move her left side. These were very tiny movements; more noticeable was how she could relax the left arm and move it away from her side several inches. She could also move her left leg. After my sessions, she was completely relaxed and happy, but when I came back for the next session, her left arm would be jammed back into her ribs, and the whole body was tense and rigid again. What was happening that kept my work from having a lasting effect? I kept wondering.

     Maribel was the proud owner of two cats, Peaches and Pixie. They often joined me on the bed as we did our sessions together. They definitely watched out for her, to make sure I brought no harm to her. Eventually, the four of us worked all together. They seemed to look forward to the sessions too.

     Over time, the staff around Maribel would change. The physical therapists and the occupational therapists told us there was nothing else they could do, and they left. New nurses came in who were more patient with, and more comforting to, Maribel. They wanted to collaborate with what we were doing and to understand how Somatics helped Maribel. They noticed how she improved with each session. Instead of tugging on her arms to get her dressed, they would patiently ask her to move her arm, and it relaxed, so she could be dressed more easily. She was no longer being forced to do physical therapy exercises that hurt her, so she was able to relax. We hit a really nice level of consistent care for her, when fewer things were being done “to help her”. Like many other things in life, less truly became more. I think we all know a few clients who do too many things all at once try to take control of a situation, and then wonder why nothing seems to work. I was very proud of what we, as a team, were finally able to achieve to help her.

     Maribel is 94 now. A few months ago, Maribel’s family decided to move her out of state. I miss not being able to work with her anymore. I have learned so many things working alongside her. It’s helped me to become a much better Somatic Educator, by taking the time to tune in more closely to my client’s soma as I’m working. Through my somatic explorations with Maribel, I was able to develop new passive movements as well as lead her through more effective active movements, that I now find also work well with other clients. Don't we all learn something from each new client we take on, which then offers others hope for the future as well? It has also made me think of my own aging parents and how I might help them to age more gracefully. I wonder how my siblings and I will be able to juggle our own busy lives, in order to come together to help our parents. And it’s made me think of how my own freedom might also be affected as I age.

     My work with Maribel has made me grateful for this knowledge of self- education that we call Somatics. Is there any segment of our lives, at any age, that hasn’t been enhanced?