Walking Back to Happiness

Peter was in his late forties and in residential accommodation  when we met, he had been the youngest child with three older siblings and was reported to have been consistently aggressive and violent towards family members.   Horrifyingly, as a little boy, when Peter exhibited aggressive behaviour he was shut in a cupboard by his father.  At the age of 3 years  his parents sought a place for him in a main stream nursery but he consistently attacked and bullied the other children.  He was subsequently removed from main stream school and placed in a school attached to a large asylum hospital, where he was admitted for weekend respite.  During his stay, Peter continually asked to be taken home.  At the age of 6 years, he was given a permanent placement in this hospital, where he spent many years with little contact from family members because of his spiralling violent behaviour.

At the age of 10 years he was described by hospital staff as a frightened little boywho continually asked to go home.  He craved affection, and continually sought reassurance from hospital staff that he had been good.  Peter was reportedly bullied by older residents and in retaliation he attacked the staff rather than the perpetrator.  When he was 15 years old, his behaviour deteriorated further and during violent episodes he threw tables and smashed windows.

Foster parents were eventually found when Peter was 23  but his time with this foster family was brief because of his violent behaviour towards them.  He was eventually returned to the asylum hospital.  Documentation stated that he required to be in the company of assertive staff members because he ‘stalked vulnerable staff’ and attacked their eyes with his finger nails, if the opportunity arose.  Behaviour deteriorated into self-harming and Peter slapped his own face with his flat hand when frustrated.

In the late 1980s Peter was discharged from the long stay asylum hospital and moved into residential accommodation with 5 other men who were struggling with similar behaviour.  Peter received 24-hour supervision from a committed staff care team.

 Behaviour in Residential Accommodation

  • Peter had violent and aggressive outburst and used his nails to scratch those he attacked.

  • Recorded attacks with his finger nails on the eyes of staff members caused severe injuries.

  • As frustration and anger built, his facial expression changed to a lip curl and a snarl.

  • He was afraid of dogs saying ‘dogs bite. Before his placement in the long-stay hospital, he had lived with his family on a farm and to keep him away from the dogs, his father had told him that dogs bite.

  • Afraid of the dark, he required a light on throughout the night.

  • He does not use names of members of staff.

  • He spends very little time in his own room.

  • Only using single words and two word  phrases  to communicate

His carers made the referral in an attempt to reduce Peter’s stress levels and to teach the staff coping strategies. He needed help to develop his communication and express his feelings in words rather than aggressively acting out his anger and frustration. It was hoped that improving interaction with care staff and helping Peter to make choices would allow him some control over his  life.

Peter’s bedroom was visually over stimulating:

  • Striped multicoloured bed cover in earth colours

  • Flowered chair cover in reds and blues

  • Patterned multicoloured curtains

  • Clutter on all available surfaces

  • Limited cupboard space to store possessions

  • Limited shelf space

  • Dried flowers in the fireplace

Setting the Groundwork

A meeting was called with care staff to explain the holistic intervention i.e. establishing colour choice, musical preference, energetic alignment and vocal toning and the rationale underpinning this approach.   It was important to establish Peter’s colour preferences for furnishings and bed linen, to share ideas and work together as a team for his benefit.

Negative assumptions that Peter had no understanding of colour and would therefore be unable to make a choice for furnishings for his room were addressed.  The care staff were reminded that when negative assumptions are made about another, low expectations of what the individual may be capable of can inhibit an individual’s potential.

At an initial meeting with Peter, I spoke to him and asked ‘What is your favourite colour?  Without hesitation he replied ’blue’.  Staff were surprised at this response but admitted that they had never asked this question.   With the best intentions, staff members anticipate the needs of their clients and in an institutional setting where meals, snacks and breaks are regimented, choice making is limited and this inhibits the opportunity to make choices and develop communication.

Goals of Holistic Intervention

  • To create a peaceful and stress -free sanctuary ( bedroom), to help him to de-escalate his aggressive behaviour.  In the hope that he would choose to  withdraw into this peaceful space in times of need.

  • To speak to Peter’s sister , to find out what (if any) music he had enjoyed prior to his removal to the long-stay hospital. This would hopefully restore a happy memory prior to his removal from home

  • To determine Peter’s musical preferences by offering a variety of musical choices and waiting and watching for a positive response.

  • To place a CD player in his bedroom so that he could listen  to his music of choice

  • We all recognise that music effects changes of mood and since ancient time music has been regarded as having a therapeutic function.  Music can release memory painlessly.  The choice of music offered has always included the music of the classical composers because each composer expresses his/her own emotions and culture through their music, which then impacts on the listener who may be soothed or stimulated by the rhythm, harmony and melody of the composition. Music enhances the imagination and awakens the brain to be receptive to positive stimuli in the environment.

  • Staff members were encouraged to use descriptive language to accompany shared activities rather than issuing commands and instructions.

  • Staff were encouraged to respond to all of Peter’s positive attempts to communicate and if he used single words to communicate, they were asked to extend his language by modelling a longer sentence in response, which includes the word he used e.g. Peter – ‘Car? ‘Response- ‘Yes, we are going in the car to the Garden Centre’

  • Removal of patterned curtains, chair covers and bed linen which may be visually overstimulating.

  • To replace the above with pastel shades chosen by Peter

  • Confirm Peter’s colour preference, by offering him a choice of fabrics in clear rainbow colours and waiting for his unprompted response.

  • Create cupboards for storage

  • To unclutter surfaces to allow free flow of air.

  • Replace dried flowers which gather dust, with fresh flowers and green plants to oxygenate room.

  • To recognise significant anniversary dates and cycles, which may be associated with a deterioration in the client’s mood e.g. date when first placed in Care, Christmas, Birthdays, disappointments, traumatic events, loss, grief etc.  The date and month of the event is relevant because the anniversary of the event may trigger the emotion of the original event and impact at a subtle energetic and physical level.  If unreleased, painful feelings associated with past events, may be re-experienced cyclically.

  • It is important not to make assumptions about the associated memory of a specific event because a happy time for one person, may be an unhappy time for another.

  • Attuning to an individual’s mood and encouraging the expression of feelings appropriately aids the process of release.

  • It’s important to remember that tears are healing.  Introducing an enjoyable activity would replace an unhappy memory.

  • Take photographs as a reminder.

  • Care staff were taught a specific method of energy alignment to rebalance and protect their energetic field and to stabilise their emotional responses.

  • Energy alignment practice was integrated into Peter’s care plan

  • Specific vocal tones  were taught and used by individual care staff at specific times in Peter’s day, to take anxiety from his mind and encourage vocal expression.

Conclusion

Peter’s behaviour gradually improved and he became less aggressive and his spontaneous repetition of the vocal tones gave him an enjoyment in interaction and carried over to an increased vocabulary and improved use of language.

Peter chose blue curtains and a bed cover decorated with blue dolphins.

I met with his younger sister who had taken an interest in Peter’s therapy and had tentatively resumed contact with her brother. It was through our conversations that I discovered that Helen Shapiro’s ‘Walking Back to Happiness’ had been a favourite of his before his removal from home.  This song was reintroduced into his life and he continued to play the song over and over again in his room on a daily basis.

Peter’s sister’s visits progressed to supervised meetings in local cafes and eventually to supervised home visits at both his home and hers.  She enjoyed tap dancing and when visiting her brother’s residential home, she brought her tap shoes to show him.  On one occasion she demonstrated a tap dance she had been learning and Peter excitedly joined in.  His care staff purchased some tap shoes for him so that she could teach him some steps.  After a period of six months my monthly monitoring and support was no longer necessary and further contact ceased.

Some two years later, I saw Peter again in the local town with a female member of staff and was delighted to see that he was no longer conspicuously walking along the pavement with a male and female member of staff either side of him policing his every move and reaction as before and he appeared relaxed and happy.

Jennifer’s Research papers and case studies are available on the Living Memory Research Trust website