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Stroke Psychotherapy (Radical Stroke

Management Therapy)

Larry has developed a number innovative of techniques that aid in the recovery of the stroked individual as well as the coping of the stroked individual’s family. He explains how to interpret after-stroke behaviour. He teaches families how to open up communication with the stroked. Also the importance of courage is explained – the courage of the stroked as well as the courage of relatives and friends. Larry helps the victim and family overcome the discouragement that is certain to occur as the stroked individual recovers. He helps the stroked individual and family as they express and receive love in new ways. The theme of Stroke Psychotherapy is to have an abundance of hope and an absence of expectations.

For more information on Stroke Psychotherapy (Radical Stroke Management Therapy), read on or call us in Toronto at 416-968-0640, outside Toronto and in the U.S. at 1-888-966-6606, and in Europe at 011-416-968-0640.

Introduction (Larry's Story)

For our anniversary we had a table at Ribfest. Our friends were invited to eat ribs, drink beer, and have fun.

This, our thirtieth anniversary, never happened. Instead of celebrating I was in a mass of pink and yellow baby blanket material over my head. And I couldn’t get out from under.

A year later I recalled what happened that night that I lay stroked in the middle of the night three feet from the bathroom in our bedroom. I don’t remember what happened next but, the next memory I have is of my son, Rory, putting on my "undies" then my being taken on a very stiff board out the front door.

For three days I fought within my mind, could hear nobody or at least could not attend to people who spoke to me. Towards the end of Day Three some probably equally suffering individual was making a heck of a lot of noise in our room, a room with boxes for beds. I realized where I was and what had happened. I had stroked and my right side was out of commission. I had one good foot with which I kept kicking my bed so that an attendant eventually had to come. He/she turned over the fellow who was making all the noise, and it stopped. The next day they moved me to a room with three men. Towards the end of that week (due to my loud protestations when one roommate departed) they moved me into a double room with an older man and I soon started in physiotherapy.

I was introduced to two forms of physiotherapy, one being physical and the other being practical (A.K.A. occupational). The person who brought me along swiftly in the practical area was a kind, beautiful, lovely and loving lady. Her approach was very effective with me.

The physiologically-based therapist was the wicked witch of the west. From the beginning she seemed to be always telling me what to do and what not to do. She was obviously inflicted upon me by the hospital that decided that a vicious woman with a Germanic accent (I later learned it was Dutch) was what I needed. They were right. She was very effective (and eventually apprehended as particularly kind and loving).

Later that week a speech therapist was added on. She was kind and attempted to be helpful. She was trying to be comforting but I found her condescending and fired her after three sessions (I guess my “true, unfortunate” personality traits were returning). While I couldn’t say ‘out’, my gesture was understood.

Then Bobby Orr came to mind. I remembered that he had done physiotherapy eight hours a day five days a week when injured playing professional hockey. And although I had not worked like that ever before in my life I decided that was what I needed until I was fully recovered – eight hours a day, five days a week. I progressed very quickly. From three people moving me forward in some contraption to two people pushing me in a much simpler instrument, to a wheelchair, to walking with a cane, and finally to throwing away my cane. From admission to departure, I left the hospital after five weeks– yes, I left the hospital after five weeks - not six months, not two years (as my physician had uttered as if I couldn't hear or understand because I couldn't speak), not paralyzed, not stroked, and in some way better than before I had stroked.

I wasn’t done. In order to deal with the “remnants of being stroked”, upon leaving the hospital I immediately embarked upon a series of private and hospital out patient therapists which I had asked my wife to set up in advance for me.

(One interesting aspect of my departure from Joseph Brant Hospital was that the reason my departure was precipitated was due to a test done at the hospital. It was found that on a test requiring a score of 90 or less to remain in the hospital, I scored well above 100. The hospital kindly kept me for a couple of days, which was generous and therefore I could leave with my new plan in place.)

My purpose was not initially conscious but I became incredibly aware of what I was doing. I was radically effecting necessary changes in my environment, my therapy and my state of mind. I was thankfully aided by my wife, whose affection and care up to that point, was pretty much limited to the bedroom – by my determination not hers. For the first time in my life I needed someone else in order to function. Perhaps the only person for whom the stroke was more difficult than it was for my wife was myself although, she alone, continues to live in the shadow of fear that I will have another stroke.

Five weeks after stroking I had about seventy percent of my eventual capabilities. Ten weeks after stroking I returned to my office but I didn’t see any patients. After twelve weeks I started seeing patients. Now it is over two years. I have a full load of patients plus I travel all over the world (again) lecturing on 21st century education as President of Individual Education International. I drive my wife crazy (as per usual) and weigh fifty pounds less. I now have 105% of my capabilities. That is ninety-five percent of my physical, plus a new modicum of general appreciation for the tolerance and help of others (especially my “kids” Rory and Elysia, my sister Rhonda, my mother, and my friends Michael and Wayne) and in particular my wife, Christine, who through her donation of talents, patience and belief in me is now stuck with her struck husband – who is his usual cantankerous but loving self.

It’s been a fine trip, but I wouldn’t recommend it. Then again, some people are destined to enter upon this trip anyway. And it’s for their spouses, children, parents and friends that I tell you about Radical Stroke Management Therapy or a more convenient term – Stroke Psychotherapy.

 

Stroke and the Value of STUBBORN

It is necessary that a stroked individual maintain a very high level of stubbornness/determination/persistence, although it will most likely be interpreted by most people as selfish stubbornness. Either it would be interpreted as a part of one’s Before Stroke personality, or brought about by the advent of a simulation of normal behaviour (After-Stroke Simulation).

How is stubbornness/determination/persistence applied? It is very important to learn to use one’s affected side for any and all activities. For example, during meals, it is quite permissible for a stroked individual to sit for one or two hours with a bowl of soup or perhaps a bowl of pudding (if they are determined to do so). The stroked AND stubborn individual would insist upon eating everything and every single bite or spoonful with the AFFECTED side. To do that, the individual would have to pinch the soup spoon between the fingers of his/her affected hand and with a pincer motion of the unaffected hand and fingers lead the affected hand to the bowl, dip the spoon in the bowl, and bring the soup to the lips.

Clearly, this would take an inordinate length of time. Doing so is a very important activity and a necessary one.

 

The BENEFITS OF STROKES

Benefits? Oh, come on now. Yes, benefits! What can we learn from strokes? Well, for one thing, we can learn patience. Stroke recovery occurs in its own way and in its own time. Stroke Psychotherapy attempts to maximize the amount of learning and minimize the amount of time required.

Before Stroke behaviour, for this author, was only having patience for children and puzzles. I was very impatient with many other things that adults did. Such behaviour caused me, and particularly those around me, more than a mere dollop of consternation.

However, the recovery of functioning from a devastating stroke depended on my After Stroke Simulation and my willingness to access my Before Stroke behaviour with patience and persistence.

This is something of which I am not particularly proud nor on the other hand about which I feel particularly negative. It is a simplification of a very complex activity, but basically a stroke happens – now deal with it.

 

Stroke and ADD

There seems to be absolutely no discussion about the value of ADD to people who have been stroked. However, when one takes a look at the way a person who has ADD operates, we can see that it would be particularly beneficial for stroked individuals. Stroked individuals do not necessarily develop easily sequentialized information gathering, but rather, gather all the information together and then assemble it and interpret it. This is typical of many people who have ADD. What ADD people tend to do is gather all the data that is available first, and then make sense of it. Is this method unscientific? No, it is a bona fide scientific gathering method. Is it as beneficial as any other learning method? Of course it is. Whatever leads to greater learning is a benefit. Is it normal? No. After all, it is ADD and it is a stroke.

 

Stroke NOMENCLATURE

  • “Stroked” is used rather than “stroke victim” because a stroke is not a state of health affairs, but rather, a millisecond experience that once it occurs, it can never be fully eradicated. This is due to the fact that the cells of the brain, unlike all other kinds of cells in the body, do not regenerate. However, the brain has the ability to have the neurological pathways altered.
  • Before Stroke behaviour: that behaviour with which we went about leading our lives before the advent of our stroke.
  • After-Stroke Simulation: that behaviour which is developed after the advent of the stroke but is intended to imitate as exactly as possible previous patterns.
  • Crumpling: this occurs when the individual senses the collapsing of the affected side when attempting to walk or take a step forward. Instead of just falling in a random fashion, the individual folds his unaffected leg under and allows himself to fall under some semblance of control. This will lead to bruising but fewer breakages. This is only necessary when one chooses to apply After Stroke Simulation of walking without proper "hands-on" supervision.
  • Remnants: those behaviours which occur, seemingly on their own, and are a reflection of the feelings and/or behaviour that was thought to be no longer active after the individual had been stroked. These remnants may occur as physiological manifestations or they may be psycho-neurological. They should be treated as unsual but acceptable. Of course, after being accepted, there are no secondary effects and they will dissipate on their own.

 

 

For help call us in Toronto at 416-968-0640, outside Toronto and in the U.S. at 1-888-966-6606, and in Europe at 001-416-968-0640.