Connecting with regressed loved ones

The holidays can be a very difficult time of year for people due to lost loved ones, holiday stress, trauma triggers, and separation from family due to severe mental illness or other reasons. While I walk through the season with my own combination of heartbreak and joy, my heart is also with others around the world who are struggling now for various reasons. One area of difficulty is when people in recovery are so extremely regressed due to psychosis or developmental disabilities that they are not able to communicate normally over the holidays and otherwise. 

Garry Prouty’s Pre-Therapy Method can help extremely regressed and psychotic persons get in touch with and strengthen their sense of self, reality and others (2009). In pre-therapy, the therapist uses "contact reflections" to help the client reconnect with reality, emotion, sensation, and the ability to communicate, by noting what is going on in the outer world or in the client or by repeating back statements that the client made (Prouty, 2009). Several studies show this method has high efficacy (Prouty, 2009). Prouty designed the method based on efforts to communicate with his own severely regressed brother, and anecdotally it has been successful in helping family members and caregivers connect with their loved ones who seem otherwise very difficult to reach. 

Have the best possible holiday season, no matter your challenges and joy. 

Figure 2.1 shows the types of contact reflections used in pre-therapy to help re-focus the person on the world around them. 

Contact Reflection	Purpose	Examples
Situational Reflection	Reflecting reality	(if happening) David is petting the cat. The child is pushing the train.
Facial Reflection	Reflecting emotions	You look sad. Your neck muscles are tense. There are tears in your eyes.
Word for Word Reflections	Reflecting words: Offers client the experience of being a human communicator	Client says, “stamp...[mumble] hat... [mumble] dog.” Therapist repeats, “Stamp, hat, dog.”
Body reflections	Reflecting bodily expression	Client stands on one foot. Therapist stands on one foot. Or therapist says, “You are standing on one foot.”
Reiterative reflections	Repeating any of the above four reflections in an effort to “re-contact”	Therapist says, “Last week you pointed to your belly and said, ‘baby.’” Or therapist repeats one of the above reflections several times in a row.

Figure 2.1. Types of Contact Reflections in Pre-Therapy. Constructed from definitions and examples in Prouty, G. (2009). Making contact with the chronically regressed patient. In D. Garfield, D. Mackler, (Eds.), Beyond medication: Therapeutic engagement and recovery from psychosis (pp. 50-64). New York: Routledge.