Clinical Holistic Medicine: Factors Influencing The Therapeutic Decision-Making. From Academic Knowledge to Emotional Intelligence and Spiritual “Crazy” Wisdom

Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the “truth telling clown”, or the eastern concepts of “crazy wisdom” and “holy madness” seems highly relevant here. The problem is how we can ethically justify this kind of highly “irrational” therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained “helpers” to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most “crazy-wise” tool of therapy

Criminal Mediation for Minors in Israel

Mediation was introduced in Canada in 1974 in order to handle a crime of robbery and vandalization committed by adolescents. After mediation, these adolescents agreed to apologize to each of their victims and pay restitution. Several countries (Canada, England, Finland, and the U.S.) have now made this opportunity available in the cases of young offenders. This review describes the process in the south of Israel. We find this method very powerful, but further studies are needed. Due to resource problems, it will not become mainstream in the near future

Intellectual Disability and Parenthood

Parenthood in persons with intellectual disability (ID) is an issue of concern for the family, guardians, and professionals as there are many sentiments and problems involved: financial, technical, medical, legal, and above all moral. People with intellectual, developmental, or other disabilities have feelings, want relationships, and are able to have children also. The attitude of society has changed through time from the early eugenic concern with heredity and fertility, to a focus on the risk to the children due to parental neglect or abuse, to acceptance and a search for solutions to parental training and support. This change can be seen as a result of a shift from institutional care to community care and normalization. This paper reviews available research, prevalence, service issues, experience from around the world, and relates to the situation in Israel. Jewish Law has been very progressive regarding the possibility of marriage between persons with ID (in contrast to American Law where historically this right has been denied, until recently). Recent research has shown that, in the case of such a union resulting in children, although they require some supervision, family, friends, and social welfare agencies have scrutinized these families so much they are in constant fear of their child being taken away. There is little information on the number of such cases and an overall dearth of information on the effects on the children, although one recent study from the U.K. has shown a varied picture of resilience and a close, warm relationship later on with the family and especially the mother

The Child With a Disability: Parental Acceptance, Management and Coping

Research indicates that family reaction to the birth of a disabled child changes according to the type of disability and the child's diagnostic category. The differences are probably an indirect consequence of anticipated or actual reactions by those surrounding the disabled child and the family, in addition to parental reactions. Many researchers have recently mentioned the positive coping and functioning of many families with developmentally disabled children. In the past there was a tendency to emphasize issues of illness and pressures, spousal strain and maladjustment within the family, while presently they are replaced with questions concerning positive adjustment, satisfaction, acceptance, and spousal harmony. Rather than perceiving the family as a helpless victim, it is perceived as a unit that adapts by a process of structuring. Professionals must acknowledge the importance of the family, this change towards a positive attitude towards disability and that the controls decisions concerning the disabled child and the family

Clinical Holistic Medicine: Holistic Treatment of Rape and Incest Trauma

Studies indicate that at least 15% of the female population in western countries has experienced sexual abuse and severe sexual traumas. This paper explains how even serious sexual abuse and trauma can be healed when care and resources encourage the patient to return to the painful life events. When the physician cares and receives the trust of the patient, emotional holding and processing will follow quite naturally. Spontaneous regression seems to be an almost pain-free way of integrating the severe traumas from earlier experiences of rape and incest. This technique is a recommended alternative to classical timeline therapy using therapeutic commands. When traumatized patients distance themselves from their soul (feelings, sexuality, and existential depth), they often lose their energy and enjoyment of life. However, this does not mean that they are lost to life. Although it may seem paradoxical, a severe trauma may be a unique opportunity to regain enjoyment of life. The patient will often be richly rewarded for the extensive work of clearing and sorting out in order to experience a new depth in his or her existence and emotional life, with a new ability to understand life in general and other people in particular. So what may look like a tragedy can be transformed into a unique gift; if the patient gets sufficient support, there is the possibility of healing and learning. Consciousness-based medicine seems to provide severely traumatized patients with the quality of support and care needed for their soul to heal

Clinical Holistic Medicine (Mindful Short-Term Psychodynamic Psychotherapy Complimented with Bodywork) in the Treatment of Schizophrenia (ICD10-F20/DSM-IV Code 295) and Other Psychotic Mental Diseases

Clinical holistic medicine (CHM) has developed into a system that can also be helpful with mentally ill patients. CHM therapy supports the patient through a series of emotionally challenging, existential, and healing crises. The patient’s sense of coherence and mental health can be recovered through the process of feeling old repressed emotions, understanding life and self, and finally letting go of negative beliefs and delusions. The Bleuler's triple condition of autism, disturbed thoughts, and disturbed emotions that characterizes the schizophrenic patient can be understood as arising from the early defense of splitting, caused by negative learning from painful childhood traumas that made the patient lose sense of coherence and withdraw from social contact. Self-insight gained through the therapy can allow the patients to take their bodily, mental, and spiritual talents into use. At the end of therapy, the patients are once again living a life of quality centered on their life mission and they relate to other people in a way that systematically creates value. There are a number of challenges meeting the therapist who works with schizophrenic and psychotic patients, from the potential risk of experiencing a patient's violence, to the obligation to contain the most difficult and embarrassing of feelings when the emotional and often also sexual content of the patient’s unconsciousness becomes explicit. There is a long, well-established tradition for treating schizophrenia with psychodynamic therapy, and we have found that the combination of bodywork and psychotherapy can enhance and accelerate the therapy and might improve the treatment rate further

Quality of Life and Persons With Intellectual Disability: Can We Measure QOL in This Population?

Quality of life (QOL) has been discussed by professionals working with persons with intellectual disability (ID) for some time, but since QOL is concerned with subjective well-being, satisfaction and happiness, how is it possible to measure, when the person in question is unable to communicate? Consciousness is believed to be an internal and personal thing, but we have done the simple experiment to ask observers to rate QOL of another person, also in sub dimensions like self-assessed physical and mental health, relationship with self, self-assessed sexual ability, self-assessed social ability, and we have found that people are able to assess the QOL rather accurate of other people. The fact that we are fairly able to read other person‘s mind and tell their state of consciousness, quality of life and quality of relationships indicate that we are able to share consciousness as an objective phenomenon. As a practical consequence we can measure QOL of people who are unable to communicate allowing us to improve care and make better decisions about life and death. We recommend observer-rated QOL1/QOL5/QOL10 for quality assurance of the medical, psychological or CAM/holistic therapeutic treatments of all patients groups that for some reason, i.e. ID, coma, psychosis, and brain damage has no sufficient language, intelligence, self-insight or ability to rate themselves. We find that the Personal-Development-Q5 (PD5) questionnaire measuring the level of personal developmental in five dimensions: emotions, mind, sexuality, spirituality and I-strength, can also be observer-rated. A strategy for measuring QOL in persons with intelligence deficits (ID) is presented

Suicide Behavior in Persons with Intellectual Disability

Suicide is one of the leading causes of death today in the Western world, and most people have had suicidal ideation at some time during their life. In the population of persons with intellectual disability, some researchers have thought that impaired intellectual capacity could act as a buffer to suicidal behavior, but the fact is that the few studies conducted in that population contest this assumption and show that the characteristics of suicidality in this population are very similar to persons without intellectual disability. This paper reviews the studies conducted and describe the symptomatology in this population. Professionals working with this population should, therefore, be aware of and assess for this behavior. Sadness, or depression, are symptoms that could indicate later suicidal behavior

Snoezelen: Children with Intellectual Disability and Working with the Whole Family

Snoezelen, or controlled multisensory stimulation, was first introduced in Israel in 1993. This paper presents a new concept of working with the whole family in the Snoezelen room with the participation of a social worker. The purpose was to facilitate family encounters with the child, to enable parents and siblings to become better acquainted with the resident through his/her strengths and special abilities, to encourage parental involvement in the care, to encourage increased visits, to improve quality of life (QOL) for the resident, and to reinforce a better relationship between resident, family, and home. Sessions were divided into two major parts. The first segment (duration 20—40 min) was free activity and the second was more structured (duration 15—30 min). Case stories are presented to illustrate the positive effects of this approach. Snoezelen can be used with the entire family with the participation of a social worker and can add new dimensions to communication