By Dominique Neuilly, General Practitioner.
In my work as a physician in a psychiatric hospital, I am regularly confronted with patients' psychic difficulties (somatisation) and with their physical problems. This is often due to secondary effects of psychotropic medications (obesity, diabetes) or addictive behaviour (alcohol, drugs). Many of these patients become trapped in a repeating cycle, with regular relapses and re-hospitalisations.
I began to realise there was a ‘missing link’ in their supporting care that no practitioner, therapy or medication seemed able to give them within the conventional medical system. Something that would support their emotional and spiritual health, helping to restore them to a state of balance.
So I began to explore the use of harmonisation, a gentle touch therapy I had been involved with for more than twenty years. It is a form of treatment included in the range of relaxation therapies (passive concentration), and has anxiolytic and sedative qualities. In my experience, it enhances the sense of physical well-being, improves quality of sleep, diminishes hypertonia, and extends the pain threshold.
Harmonisation is practiced on a person who is fully clothed, and lying on their back or their front. The person is covered by a sheet or a blanket, providing the warmth which favours relaxation. The patient keeps their eyes closed, if possible, in order to avoid visual stimulation.
Harmonisation is both a sensorial touch technique and an energetic technique. It is practiced on the patient's body by gentle touching of precise energetic zones (the famous 'chakras' described by ayurvedic medicine).
Depending on the patient's level of stress, a more or less profound state of hypovigilance may be installed, and the patient may even fall asleep. At the end of the treatment, the patient awakes from the relaxation and returns to a 'normal' state of vigilance. Usually, they experience a state of physical relief and psychic calm.
My work as a general practitioner brings me into contact with patients as soon as they are hospitalised, for their primary examination. And it is often at this early stage that I can identify patients who would benefit from harmonisation.
One such patient, was a 33 year old, woman, hospitalised for the first time in psychiatry, who had never been in psychological care.
On her arrival in the unit, she was prostrate and sobbing. She was doubled over in the foetal position and was incapable of communicating or answering the questions asked as part of her clinical examination. She was clearly in great distress, so I proposed a relaxation session, which she accepted.
I began the harmonisation while the patient continued to weep. As the session proceeded, she became progressively more relaxed, her breathing became calmer, less spasmodic, her face lost some of its redness, and her tears gradually ceased.
At the end of the harmonisation, the patient was calm. I asked her how she felt, and she replied simply “much better’ and I was then able to proceed with the clinical examination.
Another patient was a 51 year old woman who struggles with depression and alcoholism. She is very thin and physically debilitated. The beginning of her hospitalisation was marked by a number of incidents – minimal compliance with care, hetero-aggression, threats of flight, physical degradation, and frequent returns to the emergency service.
One evening, after her latest admission, I proposed a relaxation session for the next day, and she accepted.
She reported having felt warmth during the session and the impression that something was about to 'leave' her… “so that I can feel better.”
We had subsequent harmonisation sessions and the patient again achieved a sense of calm, which enabled her to vocalise what lay beneath her addictions. She told me that she was sad and cried often. She was experiencing great difficulty in stopping smoking, but on the other hand, she was now sleeping better. After another session she disclosed quietly, “You know, the problem is that I don't like myself.”
In another example, a 24 year old man was admitted after a violent and destructive episode at home. After a recent relationship breakup he had found himself unable to cope with his ex – partner starting another relationship.
He had lost 28 kilos in three months, and had an episode that left him with a broken jaw and tinnitus, “as if a bomb had exploded close to me”.
He also spoke about the death of his brother two years earlier, and about a childhood of family violence – with an alcoholic and violent father. At the end of our admission interview, I proposed a relaxation session, and he accepted.
During the harmonisation, which took place in the nurses' treatment room, the patient was calm and relaxed, and his breathing peaceful. After the session the patient said he had generally managed to remain relaxed thoughout.
Harmonisation clearly touches distressed patients at a deep level, bringing relief from pain and stress, both physical and psychological. It communicates to them the deep caring of the practitioner and reinforces the crucial therapeutic relationship.
It is particularly beneficial at the beginning of hospitalisation, for patients who are in extreme states of crisis, to the point where they are unable to communicate or speak about their problems. It's a moment when patients may also have difficulties accepting more directive forms of relaxation.
It seems to me that harmonisation could have a valuable place in the care process as a technique available to patients who are hospitalised in psychiatry. The physical approach instigated by the examining doctors could easily be complemented and supported by a session of relaxation.
This is becoming increasingly important in medicine as we strive to understand and connect to the rising tide of people who are stressed, depressed and struggling to cope with life.
I believe there is a great opportunity for greater collaboration with the other members of the medical teams - nurses, nursing auxiliaries, psychologists and social workers. Our mutual aim is to better understand the effects and potential of this therapy on the attitude of distressed patients in the ward, not only towards the medical staff, but also the other patients.
With a multiplication of these experiences with relaxation, we could then provide a true vision of its potential impact on the care environment.