Fear, Anxiety, Depression & Schizophrenia

The following is a case history of a patient who was treated by Katherine Rudolph:

Documentation Manual - Patient ‘A’

A. Therapeutic Situation

1. Institution

a) It took place due to connections at the Goetheanum, Dornach, Switzerland

2. Setting

a) The work was one-to-one.

3. Time Frame

a) The length of time was one-half hour for the first six months. Later in the six years of the therapy, the session involved one hour of work, which included one half hour of speech followed by a break of ten minutes after which approximately one-half hour of painting ensued. In response to the therapeutic need painting sometimes began the lesson, followed by speech.

4. Spatial and Architectural Location

a) The sessions took place in the house of the patient.

5. Collaboration

a) An anthroposophical doctor was consulted by telephone. He had long experience with the patient (at least seven years).

6. Description of the Therapist

a) Female

b) Age 52

c) The therapist was 52 years old

d) She had had eight years of experience

e) Her trainings were:

1) London School of Speech Formation 1991

2) Dora Gutbrod School (Therapeutic Training 2000)

3) Goetheanum Painting School 1984 – Graduate Diploma in Colour Therapy 2001

4) The artistic disciplines were speech and painting in relation to a theme chosen for, or later by the patient.

B. Description of the Patient

1. Data

a) Female

b) Age 72

c) Occupation: Housewife

d) Married

e) Living conditions: She rents a house with her husband. They are American and have lived 30 years in Switzerland.

2. Length of Therapy

a) Six hundred and sixty, one hour sessions during a six year time period, with pauses.

b) Two times per week, after six months – one to two week pauses.

3. The patient decided to begin the therapy; after about eight sessions her doctor was consulted and in agreement.

4. The patient was psychologically in a state of deep depression, very weak from lack of appetite and no enthusiasm was left. She had a history of schizophrenia for which she began treatment some twenty years earlier.

Because of an electrical treatment for backache, recommended by a friend, she suffered shocks which were too strong for her constitution, and ‘lost her bearings’, although the back pain did disappear.

5. The art therapy treatments were paid out of the couple’s own funds.

6. Description of the patient’s complaint: ‘I am not feeling well. I want to lie down.’ She repeated this complaint quite often, but she could not explain more about her condition. She was very fearful or depressed.

The doctor explained that she had been psychologically disturbed for over forty years. At this time she needed constant companionship.

Before her illness had worsened she liked to play piano and translate German.

7. Previous art therapy included speech formation and eurhythmy.

8. Further description of the patient:

a) Physical level: blue eyes, medium height, weak appearance and very stooped and thin. Sudden weight loss.

b) Sense of Life: pale, breathed-out, not decisive. Constantly changing her mind about everyday trivialities.

c) Temperament: melancholic and phlegmatic.

d) Movement: no sense of balance, dizziness, gazed downwards.

e) State of Soul: very introverted and dependent, almost autistic, flat voice. Sometimes seems to gurgle the speech on the soft palate, appears very sad.

f)Individuality: Although before her illness she was sympathetic, uncertain and more phlegmatic. First she appeared to have lost herself. There was no warmth, as a minor chord full of doom, dissonance, hopelessness.

A picture of brown, grey, as if she was screaming with fear inside, like a child bereft of ‘mother’.

Her personality is veiled over. But she participates in the therapies. She wants to follow instructions. Earlier she wanted to ‘be helpful’.

C. Beginning of the Therapy

1. A biographical process with colour and poetry in connection with the colour wheel was brought.

The patient painted the colour wheel step by step. The 7 year periods were connected to verses in a vowel mood. The verses and vowel provided a regenerating structure.

The quality of each gives a colour mood of the age. They are healthy and pure no matter what the patient actually lived through during those periods.

This first phase was conducted to give strength to the exhausted life forces.

For example: Prussian Mood:

Muttergrund

Mach gesund

was da wund

was nun ruht

nimm in Hut

heil es gut

Deine Huld

und Geduld

lőst vom Schuld

flut uns zu

Mutter du

‘A hymn to the restoring forces of motherly love’.

2. The patient was reliving childhood fears at often being left alone. In contrast, her life work was motherhood and the married life. So, to give her back her sense of self, the theme of womanhood in its many facets was undertaken:

a) ‘From the Russian’ Soloviev

‘To you, O earth mother, I bow my head

And through the fragrant veil of your being

I sense the flame of your heart

And its universal pulse beat

The midday sun sends its piercing blessing

Of scorching rays down from its radiant dome.

And in this quiet splendour the sound

Of free-flowing rivers and joyous forest voices gushes forth

And in the bright glow of flaming love

Earth’s sorrows scatter like dust.’

b) With this poem the patient painted a nature scene with a waterfall evolving out of blue and yellow. It was gradually enhanced to green and orange. The polarity was at first diagonal as experience and then above and below in a mood where man and woman were painted in a place where they would be comfortable as human beings.

3. The following poems were done together for the same theme.

Hymn To The Earth

‘O Universal Mother who dost keep

from everlasting thy foundations deep

Eldest of all things, great Earth

I sing of thee’

- P B Shelley – translation of Homer

and

‘Sacred goddess, Mother Earth

Thou from whose immortal bosom

Gods and men and beast have birth

Leaf and blade and bud and blossoms

Breathe thine influence most divine

On thine old child Proserpine’

including ‘Come Hither’ and later ‘No Coward Soul am I’ by E Bronte.

These poems had a connection to Nature. ‘Andromeda’ by Kingsley was also done in hexameter. This is a poem to disperse fear.

The patient was able to identify with these poems in her life-role as wife-mother. She was however very withdrawn – although always ready to try however depressed and frightened.

4. Goethe’s poem was taken ‘The Metamorphosis of the Plant’. The hexameter verse allowed the depressed state to be somewhat alleviated by concentrating on the growth of a plant. All the inner turmoil was directed to observing and painting the plant.

This was a second phase in the therapy. The patient was over the initial crisis.

Then it was decided to take themes about which one might say, like Goethe:

‘All of the forms have a likeness yet none quite resembles the other

Thus is a hidden law revealed from a view of the whole’.

The patient chose the theme ‘Mountains’. We began with a poem written by Arvia MacKaye-Ege, who was a friend of the couple.

With this theme, mountain landscapes were painted:

Bold Mountain

‘Bold Mountains

Carve me with your rugged might

Give me the power to stand

One with the wide clear land

Will to fight

Through weight of granite might

Breaking aloft to rise

With quite carven thought

Into the crystal heights of starry skies

Girdled with glacial flow

Mantled by silent snow

Grant me the power to grow’

The poet, who passed over sometime before meant a lot to the couple and it was a great comfort, and help to the therapy to speak her poems.

The plant and mountain paintings were on dry paper grounded with one or two colours in veils. The enhancement of the initial grounding was often from above with the warm colours to below with the cool colours. Yellow was in the middle and provided the growing space for the plant or the mountain atmosphere.

The healthy sequence of colour, allowing each colour to ‘speak’ before the next is taken, bringing balance to the whole: all created a world of harmonious social accord.

D. The Course of Therapy

1. Festival verses and paintings following poems by Arvia MacKaye-Ege ensued. This was comprising the last two years of therapy. The patient had a devotional nature which was rekindled by the poetry. Madonna paintings and the Easter Sketch by Rudolf Steiner were used with poetry:

Michaelmas

‘O You who have given me, Your all

To be my all for me and selflessly

Have set me free…

With all my heart, my mind, my will

Freely I take your gift

Freely strive to be to become to live

This new world mystery of me

To do free deeds of courage

And of love for the good, the beautiful and the true.

Conceived and wrought

With heaven-lit, heart-forged

Thought’

The therapeutic relationship developed as the patient slowly improved in the sense that the fear aspect was lessened, although the depressions were intermittent.

2. The sevenfold process

a) Receiving: In spite of her condition, the patient showed interest.

b) Uniting: She had a very strong dependency and followed instructions.

c) Deepening: The counter-moods of fear and depression were obstacles.

d) Standing firm: She was able to identify with the colour qualities.

e) Independence: She could never bring her own initiative; although she was able to choose her own theme when asked (the theme of mountains).

f)Letting go: One colour is allowed to balance, ‘speak’ until it has no more to say. This process was always encouraged by the therapist.

g) New Birth: The process of the painting is carried through. The therapist had to suggest when the painting had reached its culmination. Asked what would be next. The final mountain painted was ‘named’ by the patient ‘Egypt’. This was a milestone for the almost autistic melancholic.

E. The Goal of the Therapy

1. The long-term goal was reached in that the patient could slowly begin to make her own colour gesture, when something was suggested. The study of the elements was the final theme. The fire of courage was painted.

Although she remained very melancholic, her voice was firm and strengthened from doing many articulation and fluency exercises preliminary to speaking the poems. Often she had her paintings displayed on the walls.

The patient still does not like to be left alone, but now the old couple has moved to a nursing home where there is always a nurse fairly close. She is enlivened by the artistic therapy and it penetrates her being.

F. Prognose

If the patient continues after a pause again, the therapist would best encourage her to become more independent. Considering her condition she might now be able to enjoy painting with a group. Social contact would be good in the therapy.

© Copyright 2005 Katherine Rudolph, Exploring The Word In Colour And Speech