My client Dr. John B., a 40-year-old surgeon, has an interesting story: About three years ago, a child jumped onto his upper back while he was swimming in a public pool. He suffered strong whiplash-like symptoms from that impact, including vegetative and emotional reactions, to such a degree that he had to rest in bed for about a week. After that, he recovered well and returned to his previous active-happy-healthy lifestyle.
Unfortunately, about two years later, he injured his head again: While he was loading the trunk of his car, the top of the trunk fell onto his head. He got a deep bruise, but showed no signs of a cerebral concussion or vegetative reactions. Yet since then, he has had an odd and annoying difficulty: he keeps bumping his head into door frames, lamps, windows, car-door frames, etc. This happens at least twice a week (usually more often), so that his head is constantly covered with several recent bruises.
John is intelligent, active and open-minded. He relates the head-bumping incidents with good humor; and doesn’t allow them to dampen his enthusiasm for life-not only in his work, at which he seems to excel, but also in his private life with his young daughter, and in his weekly basketball games with his friends. John has been a passionate and talented basketball player since his high school years, and the weekly game is an essential contributor to his sense of bodily vitality. But in one of our sessions, he mentioned his sensation of getting older, his legs having lost the speedy acceleration and jumping power they had had since his high school years.
After several sessions, John’s overall alignment with gravity had improved – although because of the continual head bumps, he could not keep the sense of lift through the upper pole between sessions. What’s more, the work on his legs and pelvis had not restored the agility of his legs as he had hoped it would.
What could be done? My considerable work on John’s head and neck had not reduced the frequency of his head bumps. Between sessions, I kept thinking about his head’s disoriented behavior in space. Why did he continually bump his head? Was it a subconscious urge to repeat the two previous traumatic head injuries? What approach would best help him reduce the head collisions?
One day I reviewed some recent research on the development of the cortical body image in humans and certain great apes. Several exciting articles by the young American primatologist Daniel Povinelli especially caught my attention (see www.cognitiveevolutiongroup.org). Behavioral studies indicate that only humans, chimpanzees and orangutans develop the capacity for physical self-conception; i.e., mental representations (images) of their bodies, which include weight, proportions, shape and relative orientation in space. This internal body representation allows the arboreal chimpanzees and orangutans to move their heavy bodies through the fragile canopy with nonstereotyped locomotion, whereas the smaller monkey-, or even gorillas, who typically do not live in the canopy – employ more discrete movement schemata and do not develop the self-imaging function. A human usually shows first signs of a body image at the age of 18-24 months, when it starts to react to its mirror image as a representation of self.
I wondered whether John’s orientation problems arose from a faulty internal body representation. Perhaps the two initial injuries made him “lose his head” in his brain’s subconscious body schema.1 Maybe the internal map on which his brain was planning and monitoring his movements in space lacked a functional and adequate representation of his upper pole. Had John lost his head not anatomically, but in his body schema? And if that were true, how could we re-integrate his head into his body schema? Just touching and massaging his head and neck had not helped much.
Listening to John, I was reminded of something my father told me during my first ski vacation as a young boy. As I carried the skis over my shoulder, I would continually bump their tails into other people and things around me. My father’s repeated admonition, “Keep your awareness on the very ends of your skis, Robert,” was not easy to follow. Yet after two days of paying conscious attention to the position of the tails as I walked and turned – as well as several dozen involuntary collisions – I stopped bumping the tails without even having to think about it. It was as if the skis had become a part of my own body.
Perhaps I could help John reintegrate his head in a similar way. First, John and I discussed the possibility of his wearing a helmet, with which he could perform some careful and conscious head maneuvering and bumping exercises in relation to hanging objects. Eventually, we settled on a better, more practical idea. How about suspending balloons from the ceiling in his home- e.g., over the kitchen table-so that he could experiment with subtle balloon bumps? John liked the idea of the balloons better than the helmet, and agreed to try it. The concept behind it made sense to him.
A week later, John returned as a vibrant man with one of the widest smiles I have ever seen. Not only did he play with suspended balloons, but he also added a few amusing head-to-head games with his daughter that incorporated the balloons. Amazingly, the past week was the first one in a very long time in which he had not once bumped or bruised his head. Plus – and this came as total surprise for both of us – he had played “the basketball game of his life.” In his words: “Every piece of trash I got, I could turn into a basket”. Apparently he had regained the speed, agility and jumping power of his legs to a degree that he could accelerate faster and jump higher and with more precision than before.
John and I both suspect that his dramatic improvement at basketball was indeed related to his having “regained his head” in his body schema. Evidently, the simple exercises and games with his daughter – which took maybe 20 minutes-allowed his brain to reintegrate his head into the subconscious schema of his own body. This makes sense, dear reader: If you are trying to jump, but encounter an unexpected six kilograms of weight at the upper pole, it stands to reason that your acceleration will be slow and your precision impaired.
John’s improvement seems stable. In the following weeks, his head remained free of bumps and bruises, and his restored agility on the basketball court remained. Further sessions did not do much more for him.
What a detective story! It reminds me of what Peter Melchior, one of my original Rolling teachers, told me in my early years as a practitioner: Maybe it is more that people change “their minds about their bodies” in response to our treatments, which then results in physical changes of the bodies themselves.
As does any good – and true – success story, this one raises several questions. For example:
·Would the simple balloon exercise have had the same effect, had John not put himself into a meaningful social interaction with his daughter?2
·If he or I had come up with this simple treatment idea in the first session, could he have gotten the same degree of improvement then?
·Perhaps many of our clients have dysfunctional body schemas. How about “the woman without a hip joint” or “the doctor who lost his toe hinge.”3 Could it be that we can permanently “cure” cases like these with simple 20-minute interventions? I certainly would love to have more cases like this in my practice – or to recognize them more often.
1.Based on the convincing arguments of Gallagher and Cole, it is useful to distinguish between body schema and body image. Body schema is a system of usually preconscious, subpersonal processes that we use to monitor posture and movement. In everyday life, the body schema operates “under the radar”, and in many cases works best when the intentional object of perception is something other than one’s own body. Body image, by contrast, refers to ideas or mental representations about one’s body. It consists of intentional states – perception, mental representations, beliefs and attitudes – in which the intentional object of such states is one’s own body. There are several interesting correlations and interactions between the body schema and body image. See Gallagher S. & Cole J., Body Image and Body Schema in a Deafferented Subject, Journal of Mind and Behavior, Vol.16 (Autumn 1995), 36990.
2.One might also explain the results from a perspective of post-traumatic stress disorder: The second injury – which triggered the ‘head-less’ coordination – could be seen as a re-traumatization, which caused a fearful ‘splitting off’ of the injured body part in the subject’s the internal perception. The gentle movements with the head and balloon then provided an ideal ‘titration’ of this former threatening stimulus direction, similar to someone who had been abused by a man with a beard learning through psychotherapy to perceive other bearded mean as non-threatening. The good relationship between the client and his daughter could be seen as a ‘resource’ in the process of trauma resolution. As plausible as this concept might be, it seems more convincing to me that the improved agility in running and precision in jumping and throwing can be more specifically explained by the body schema concept.
3.The title and style of this report were inspired by the wonderful book The Man Who Mistook his Wife for a Hat and Other Clinical Tales, by Oliver Sacks, M.D.