There was Blom (flower) and Mielie (a head of maize}. Blom spoke into the one ear and Maize into the other. Mielie said "Just go on and do it!!" Blom said "No! no!! - that's not you. It's not right".
Full psychiatric evaluation showed no schrizophrenia. Sometimes Mielie won and sometimes Blom. Given a chioce, we would ask "What does Blom say?" Where do these id, and ego and superego voices come from ...Ancestors? Over time we all knew that Blom and Mielie were real heard voices for the boy.
She was sat with a group of girls in the foyer. Normal girly talk complete with teenage giggles - all very light-hearted. It was comfort for her. She needed this.
I stood at the tea-wagon. She and two others sat facing it. The rest of the group were on the other side of the coffee table and facing her.
I say it was what she needed because she was grieving the tragic death two weeks previous of her 21year old boyfriend Len. It was a serious relationship with the promise of marriage when she turned 18 - which was soon.
Suddenly her eyes fixed on the main door of the facility which opened up into the foyer.
"Len! Len! It was a deeply emotional cry. Her body stiffened, her eyes opened wide. She twisted. her body and eyes tracked from the main door to behind her and up the stairs to the girl's dormitory.
"Len! Len!: Then tears,i
'Did you see Len?" one asked.
"It was Len. Len came. He went up stairs.
Not one girl questioned it.
When the news came from the hospital that their mother had died, we followed our standard procedure. We asked that the body not be removed until the two were taken by the child and youth care worker to the hospital and the bediside of the mother's body . They took flowers., placed them on the mother's chest, kissed her forehead took her cold hand and said their goodbyes.
They had to experience the reality of her passing.
Time elapsed as we waited for the family from Zimbabwe. It was a full funeral service attended by the children, with the coffin present. They again had flowers to put on the coffin before it was wheeled out.
She was cremated and the relatives took the ashes to Zimbabwe .
Telephone calls were made to the two children from Zimbabwe. On more than one occasion they told us, The Zimbabwe family had said "Your mother is safe with us." Meaning the ashes were urned and on the shelf above the frireplace awaiting internment.
From snippets of conversation the child and youth care worker joined the dots. The two children were living with the delusion that their mother was alive and living in Zimbabwe awaiting an internment At the hospital, they thought that the mother was just sleeping... she looked like she was sleeping. The funeral was just something we all went to as a Home.
Hasty footwork had to be done. The Zimbabwe relatives were persuaded to bring the ashes to Johannesburg. An internment was arranged. The two children held and placed the urns into the wall of remembrance. They were told to tell us all what they remembered about their mother now gone forever. The cubicle was sealed with a plaque. They helped. There were tears....at last !!! Good healthy tears.
A friend brought her to the office "She has not been at all well" she said. "It seems like she's in another world...like she's not connected." She had asked to see her children.
"Let's talk a bit while we we call the children"...structural delay.
Fear struck suddenly, looking towards the door, "They're coming! They're coming!"
"Who's coming?"
"They are coming. They are coming to suck my blood and take me away. Only the blood of Jesus can stop them. They are coming."
"I can call upon the blood of Jesus and chase them away" I said.
Putting my hands without contact around her head, I said the words I thought were needed. "Out...Out In the name of Jesus.
She stiffened like a board, like a plank of wood, resting her neck on the chairback and her legs outstretched in front of her. Then she slumped into a coma. like state.
The resident nurse was called and the ambulance. Vitals were taken. They were fine.
The Psychiatric ward did wonders and after three days she was discharged.
At the back of this episode was a true story which had an indelible effect on my practice.
A woman in a psychiatric facility for some or other condition refused to eat. This was unrelated to her diagnosis. It didn't matter what they brought her, or what they did, they could not persuade her to eat. The doctors and the psychologists did all they could. But...Nope!!
She was fading, wasting away and would surely die.
A young intern was the only one who had been part of the treatment procedures asked to be allowed to try. It was agreed. "OK, you try."
he went to her bedside . She said,"Im not going to eat. They are trying to poison me". '
"You're right he said. They are trying to kill you. They're not trying to poison you. They want yo to starve to death.'
That evening, she ate.
"What did you do?"
Our best qualified professionals tried and she didn't eat. What did you do?"
'I needed", he said "to step into her world for a moment...into her reality. Her fantastic delusion is her reality. I agreed with her reality as a start and worked from there".
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