Riverview Hospital for Children and Youth. Richard J. Wiseman

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СКАЧАТЬ I volunteered to work with Lester, a six-year-old autistic child whose parents had requested a psychological evaluation. Working with that little boy turned out to be one of my most valuable clinical experiences at MSU.

      When I opened the door and entered the waiting room to greet Lester and his mom on that first day, I found Lester cowering in the corner. Instead of approaching him too closely, I told him who I was and invited him to a playroom down the hall. I then moved aside so he could pass me at a distance. He ran through the waiting room and into the play area. He quickly surveyed all the room’s features, making sure to keep distance between us. After opening and closing every cabinet and drawer, he pointed at each animal picture hanging on the wall as he said, “coowwwmooooooo,” “sheepbaaaa,” identifying with, or “becoming,” that animal.

      I asked him if he wanted to sit down at the table and draw a picture of a person—a standard testing method. He ignored me and continued to investigate the room and its belongings. Finally satisfied, he sat down at the table, picked up a pencil, and began drawing. At first I saw no connection between his illustrations and my request. It wasn’t until I 1ooked closely that I could see that, in fact, he was telling me exactly what I wanted to know. Lester drew Humpty Dumpty having fallen off the wall and broken; a cracked Easter egg; and several balloons, some with faces and others that had popped. The image of a fragile little boy was obvious, but I had no idea yet of the profoundness of this feeling.

      During our sessions over the next several months, once a week for one hour, Lester became more and more preoccupied with the balloon imagery. He wanted to play with balloons, but would not let me blow them up, although he would pretend to do so. I learned from his mother that he had a closet full of balloons at home that nobody could go near without setting off a panic in him. One day, someone who had previously used the playroom left a filled balloon in the room. Lester was terrified. He kept one eye on it all through the hour from the opposite side of the room; and he would not allow me to go anywhere near it, even when I offered to retrieve and remove it.

      As time went on, the balloon imagery began to include a person contained inside something. Eventually Lester started playing with an airplane, which he placed in one hand while the other hand pressed a small doll against the bottom of the plane.

      During the first ten months, Lester pretty much did as I asked, while I did a running commentary, trying to be supportive and interpreting what I perceived to be the feelings, worries, and fears behind his activities. If he needed help with something, he would simply take my hand or push me toward the task. However, he did not respond verbally to any direct question.

      One day, after a long Christmas recess, Lester returned to the playroom and I greeted him with a casual, “Well, what did you do over the Christmas vacation?” Without uttering a word, he went to the blackboard, which covered one whole side of the room, and began drawing. There was the YMCA swimming pool, a bowling alley, a Christmas tree, Santa coming down the chimney, presents, Lester opening one. He drew until he got to the end of the board. Since he hadn’t finished his story, he turned around and walked back to the beginning of the blackboard and simply continued to draw over what he had first drawn. Occasionally, he would realize something was not clear and fix it. This form of storytelling took Lester the entire hour. When he was finished, I thanked him for telling me about his vacation. He was very pleased—and so was I! It was the first time he had communicated directly with me in response to a question.

      As the weeks went by, the airplane with a boy clinging to the bottom began taking more and more precedence in his activities. He’d fly the plane and doll back and forth “to California,” making sure there was no separation between the two. I began commenting about the imagery: telling Lester how it was like a boy being in a balloon or like a baby being born. I suggested that it was all right for the boy to come out of the plane. The boy would be safe because I was there to help him.

      Then one day it happened! After flying around the room several times, holding the boy tightly against the belly of the plane, Lester took hesitating steps to separate the two, and with further encouragement on my part, he finally pulled his hands apart, separating the boy from the plane. He was ecstatic, jumping up and down and brimming with self-satisfaction.

      He then walked up to me said, “You say to me ‘What’s your name?’ and I will tell you ‘Lester!’”

      I said to him, “What’s your name?” And he very proudly replied, “Lester!” After repeating the entire scenario several times, he said, “I will say to you, ‘What’s your name?’ and you will say, ‘I am Mr. Wiseman.’” And so I did. After repeating this several times, he went around the room, pointing to each animal picture on the wall, saying, “This is a picture of a cow” and “Here’s a picture of a lamb,” until he identified each of the animals. I said to him, “It’s like you are seeing them for the first time.” He looked at me and smiled.

      Lester was born.

      During the next several months, Lester used personal pronouns and began to lead me through his developmental stages—right out of Freud’s books. Lester took complete control of our sessions, taking me by the hand and instructing me on my role in the various scenarios that he wanted acted out. For example, first I was to be a “mommy bird” as he would chirp around the room, come back to the nest, sit on my lap, and open his mouth for me to feed him. This scenario became part of every session for several weeks. Gradually the emphasis changed, and I became the “big bad wolf” and would have to chase him (and not catch him). Scenes were enacted with big “daddy bears,” nighttime monsters, airplane trips to California, all having a theme of horrible things happening from which I was to protect him.

      On one very dramatic occasion, Lester told me he had to go to the bathroom and asked me to go with him. When he flushed the toilet, he showed obvious distress and we quickly returned to the playroom. He then said, “Pretend I’m falling into a big hole.” He began sinking slowly to the floor. I went to him and said, “I will help you,” and extended my hand. He grasped firmly and pulled himself out.

      Eventually, we managed to get Lester into mainstream school classes, where he prospered. One day he proudly announced to me that he was president of his class, which meant he led his classmates in the pledge to the flag, lunch count, and so on.

      During my appointments with Lester, my faculty adviser treated Lester’s mother using hypnotherapy, with apparently equally dramatic results. Interestingly, Lester’s father was a professor of communication skills at the university.

      ON TO CONNECTICUT VALLEY HOSPITAL AND THE CONNECTICUT SERVICE CORPS

      Upon graduating from Michigan State University I landed a job at CVH. After two years of doing psychological testing on adults, I grew tired of the emphasis on testing and the deemphasis on the patients themselves. It was during this period that I decided one day to accompany a fellow psychologist who did some volunteer work on the new Children’s Unit, as discussed earlier. The horrifying images are still vivid. The fact was, I was told, this setup was a big improvement over previous conditions! The children there had come from the three adult psychiatric hospitals, always living on adult wards.

      Having just come from the Hawthorne Center in Michigan, a new, state-of-the-art children’s program, where I worked with Lester, I was appalled.

      Two years after accepting the position as a CVH psychologist, I accepted a new position: director of the Connecticut Service Corps, which included running a summer program for adult patients from the hospital’s back wards (occupied by long-term patients whose condition was considered chronic). That first year we rented a Girl Scout facility, Camp Laurel, and the next year we began building our own on an abandoned reservoir site in Danielson, what would become Camp Quinebaug. During my four summers living in a tent, I witnessed the devastating effects of long-term hospitalization. Being a “patient” was self-defined, СКАЧАТЬ