After spending a week observing and participating in patient activities, I started brainstorming what unique skills I could bring to the psychiatric hospital. I drew largely from my previous experience working at The Health Center at Lincoln High School.
One form of alternative care model used effectively by the counselors at The Health Center was mindfulness. Mindfulness was taught to students in individual counseling sessions or through larger group activities. It is a form of self-care that students can practice in moments of high anxiety.
Essentially, mindfulness is a mental health practice that can reduce stress. It is simply about being mindful of what you’re thinking and deciding where you choose to focus your attention. Have you ever walked from one room to another room without realizing how you got there? This is an example of being asleep in your day, not being fully alive or present.
I decided to introduce my adult patients at the psychiatric hospital, many of whom had a diagnosis of schizophrenia, to activities that promoted mindfulness. I chose to use mindfulness as my guiding principle in creating this 3-month program for a couple of reasons. First, mindfulness was a concept that Moroccans were not often familiar with. Though, many members of the hospital staff showed enthusiastic and open-minded responses when I explained the basic philosophy behind mindfulness.
Most importantly, however, research has shown mindfulness meditation training to be effective in empowering schizophrenic patients to manage distressing and negative thoughts or beliefs. This may be because mindfulness can increase activity in brain areas associated with attention, emotion regulation and anxiety. Mindfulness also facilitates neuroplasticity—the creation of new connections and neural pathways in the brain.
Furthermore, mindfulness can be an excellent complement to therapy and medication for people suffering from mental illness. It can be incorporated into almost any daily routine or activity. I incorporated mindfulness techniques in art, music, writing and dance.
For example, I asked patients to roll small amounts of clay into little beads. Instead of chatting, each patient was asked to be quiet, to bring their attention to the piece of clay, observing it carefully as if they had never noticed clay before. I continued to quietly give them prompts such as: how does the clay feel between your fingers, what kind of textures do you notice, what thoughts pop into your head as your roll the clay back and forth? When the participants felt ready, they put their ball of clay to the side and picked up a new piece of clay. At the end of the day, I pricked holes into each of the beads. The next week, when the clay had dried out, I created a bracelet with each patient’s beads. The purpose of the bracelets was two-fold: to remind patients about being mindful and to give patients a tool to self-soothe. The bracelets provided the patients something safe, comforting and tangible to touch when feeling upset.
Ultimately, the success of my program was difficult to determine. This was mostly due to the communication barrier I faced every day. In Morocco, I communicated almost exclusively in French. While I was able to converse fluently with the hospital staff, I struggled to communicate with patients who understood little to no French. Therefore, I relied heavily on the nursing staff to help me translate from English to French to Darija. And this lack of direct communication went both ways. When participants responded to my prompts, I needed a nurse to translate their comment back into French. I believe that a lot of information got lost in translation.
My impact also depended upon the functioning level of each patient. Not all patients were physically able to participate in activities that involved speaking, reading or writing. This was a challenge I had not anticipated and, consequently, had to adjust to. On the flip side, higher-functioning participants sometimes grew bored with the simple activities. It was a constant balancing act, and I don’t know if I ever truly found the sweet spot. Perhaps there wasn’t one to be found with such a diverse group.
Nonetheless, I was constantly surprised by the level of understanding and self-awareness the patients exhibited now and then during these activities. Even those with low-cognition had moments of artistic and philosophical insight. An awareness of mindfulness practice is sometimes enough to help slow down initial reactions spurred by stress. By presenting patients with a wide-array of ways to practice mindfulness, I hope each patient was able to find one that resonated with their individual needs.