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Attention Deficit Hyperactivity Disorder
Soma Brings Peace of Mind to Families

By Karrie Osborn

Originally published in Massage Bodywork magazine, June/July 2004.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.



Drawing 1 -- Before any Soma work. This drawing was created by an 8-year-old boy before experiencing any Soma work. He was told to create a picture of himself as he felt in his body at that moment. Through drawing analysis, this picture depicts a desperate-looking person, says Karen Bolesky, co-director of the Soma Institute of Neuromuscular Integration. The black lines indicate internal organs, their presence here often a sign of paranoia. Black is usually a color of grief or pain. The fact that the child used both a pencil (indicating the need to be correct -- a trait common to the left hemisphere of the brain) and the red and purple boundary, shows a sense of anger and feelings of abuse. He is feeling closed in and overwhelmed by these feelings. The mouth is held in a scream with teeth showing, also a sign of anger. The person is off-balance in the picture, something the child says he felt.
The statistics for children afflicted with attention deficit/hyperactivity disorder (ADHD) are, in all estimations, staggering. By conservative accounts, there are more than 2 million children (3 percent to 5 percent, or one to two children in each classroom)1 afflicted with this disorder, which causes inattention, impulsivity, and hyperactivity in its sufferers. Other more progressive estimates project that 10 percent of the school-age population has ADHD, also known as attention deficit disorder, with another 20 percent demonstrating symptoms.2

The prevalence of ADHD has increased significantly over the past three decades and is now considered the most frequently diagnosed childhood behavior disorder today.3 While alternatives for addressing the disorder (such as nutrition and homeopathy) are now being considered, pharmaceutical solutions are still the No. 1 recommended option for children diagnosed with the condition. In fact, up to 90 percent of children with ADHD receive Ritalin or similar stimulants.4 Sadly, our classrooms are filled with "doped-up" kids.

But what if there wasn't a need to medicate 8 million-plus children for their ADHD symptoms? What if we could turn to bodywork to address their needs?


Drawing 2 -- After three Soma sessions. Even though the instructions were the same, this picture denotes a much different child. It depicts his father, brother, and himself eating a meal together. He is the figure on the left, still alone, but in a much better place. The child's parents had recently divorced, and the children were living with the father. He said the other chair was empty for his mother and that he missed her. Bolesky says it's important he recognized those feelings. The drawing indicates the child is feeling more in his core brain and doesn't feel so boxed in. The color brown seen in the picture is a healthy color and indicates being in touch with nature. The light hanging over the table is brown and yellow -- the color of energy. This drawing shows a healthy sense of reality, less isolation, and is much more positive overall.
That's the question Karen Bolesky asked when she first started treating children with ADHD nearly a decade ago.


Soma and ADHD -- A New Frontier
Soma Neuromuscular Integration is a body/mind therapy that addresses the needs of a person's physical and psychological being. Based on the work of Ida Rolf, Soma utilizes a protocol that seeks structural balance and a reconditioned nervous system through deep tissue manipulation, movement training, communication between client and practitioner, journaling, repatterning, drawing interpretation, and more.

While the body is being worked via the fascia, the neurological work is occurring on physiological and psychological levels, says Bolesky, co-director of the Soma Institute of Neuromuscular Integration in Buckley, Wash. "Work in each area affects the other, so structural improvement is seen as much a function of neurological change as of fascia manipulation."

Bolesky has offered Soma bodywork to approximately 50 children with ADHD during the last six years and has had nothing but positive results. She started working with these children after receiving referrals from a local physician.

"The thing I see most is a calming kind of behavior," says Bolesky of her ADHD clients after working through Soma's 11-session neuromuscular integration paradigm. "It's an observable behavior change, often with them having fewer social arguments and less hostility. They are not so isolated and have more of a sense of community." For any parent whose child has ADHD, that's saying a lot.

So why does Soma work with ADHD when other therapies don't? First, let's take a closer look at the disorder.

While the causes of ADHD are not absolutely known, some believe it may be triggered by everything from a brain injury (subsequent to trauma, disease, or fetal exposure to alcohol) to lead exposure.5 There is even a theory that heredity is a factor.6 A child's diet, often filled with sugar, preservatives, artificial coloring, and other chemical additives, while not a causative factor, is considered something that exacerbates the condition.

There are many unknowns with ADHD, and as illustrated earlier, the biggest uncertainty is how many children "really" are afflicted with it. Even governmental agencies show conflicting numbers. Adding to this dilemma, the disorder is often misdiagnosed or too quickly diagnosed. Depression, insomnia, poor diet, and a variety of behavioral problems may be confused with, or appear in conjunction with, ADHD.

What we do know is that there is indeed a difference in brain activity between ADHD children and those not afflicted with the disorder. According to G.W. Hynd et al., ADHD children have a difference in the "pattern of the brain morphology in the frontal region."7 Advanced neuroimaging techniques show that the brains of ADHD children handle neurotransmitters (such as dopamine, serotonin, and adrenaline) differently from their peers.8 According to Jay Gordon, M.D., a "deficiency in central nervous system dopamine probably causes many, if not most, of the problems associated with ADHD."9

Bolesky believes that ADHD is the result of a fixed dominance in the left hemisphere of the brain. "All (my) clients diagnosed with ADD or ADHD ... show left hemisphere dominance to such a degree that it becomes aberated into overdominance,"10 she explains. Creating an integration with the other aspects of "brain" -- under Soma's Three-Brain Model -- will allow greater attention span, ease, and well-being for the client. Integration through Soma work will allow these children the chance to find the balance they so desperately need. And because the changes they undergo via Soma are permanent, Bolesky is convinced ADHD is not biologically based.


Soma's Three Brains Explained
Bolesky says Soma bodywork is "effective in expanding the internal experience of the person to a more integrated state. Integration allows greater exchange between body and the mind, which then releases the state of overwhelm" felt by those afflicted with ADHD.

An integral and unique aspect of Soma Neuromuscular Integration, and the likely reason why this therapy works with ADHD children, is the concept of Three Brains. Soma developer Bill Williams coined the term as he began to conceptualize this modality and the integration process in the 1970s.

Most of us are already familiar with the concept of left and right brain functioning. The Soma model calls for a mid-brain or core in which emotions are seated and in which healing, in conjunction with the right hemisphere, occurs. The implication is that a healthy integration consciously utilizes all three aspects of the brain when appropriate and that the brain is not separate from the body.

The left hemisphere is considered the dominant brain in our culture, Bolesky says. It is linear and oftentimes forgets the body. It is said to only be able to handle 16 bits of information per second, and is thought of as the survival hemisphere, but in planning and thought only -- not in action.

The right hemisphere is a place of inspiration and connectiveness. Bolesky explains that time in the right hemisphere is like floating down a river and absorbing whatever you encounter. "This is a brain of no effort; just being and bringing forth," she says. "It is the place of reverie and daydreams. In computer terms, this would be the modem to all computers in the universe. The power and energy perceived here is infinite."

The core, or central nervous system, is primarily responsible for the production and control of energy. It is the power plant of the body, Bolesky says. It is here that feelings reside and in which a connection between the right and left brain exists. "The core for us is the central nervous system, but bigger than that, it's also the hara, the center, the part of us that is the body brain. It's the deep part of us that connects -- the energy source."

When utilizing Soma, the goal is to create an environment (using this model) in which "the client begins to experience and have volition over which brain is more effective in the present moment or present task," Bolesky says. "It may be more effective to have access to another brain than the more dominant left hemisphere for optimal functioning." Soma is designed to reintegrate the three brains to create increased function, wellness, and wholeness." (For a more in-depth discussion of the Three-Brain Model and Soma Neuromuscular Integration, see Soma on page 20.) In helping clients access all three brains, greater expansion and personal ease is found.

After working through the Soma program, Bolesky says the changes are palpable. "Kids are usually the ones who tell me how much better they feel, how much better they're doing in school, and that they're not so mad any more," Bolesky explains. "It's a beautiful thing to see them understand their changes."


A Case Study
The thrust of Bolesky's work with ADHD children began nearly a decade ago when a local physician referred her an 8-year-old boy. Bolesky says the boy's family was at wits end with his aggressive behavior. He was in such dire need of help that he was in danger of being removed from his school environment.

Considered a bright child, the boy had been seen by both school and private counselors in an attempt to squelch his negative, disruptive behaviors, which included poor manners, inability to follow directions and work quietly, aggressiveness with other students and siblings, and failure to accept responsibility for his behavior.

Bolesky discusses this case study in the book The Indigo Children, by Lee Caroll and Jan Tober. She writes: "He played lots of computer games which are very results-oriented, left-hemisphere actions. He hated to be wrong and liked to be alone when nervous ... He had good mental awareness of his body, but felt uncomfortable in it most of the time."

Using the 11-session protocol of Soma Neuromuscular Integration, Bolesky set to work on the child. The first session was plagued with the boy's attempt to resist and distract himself from taking hold of body awareness. Bolesky let the child know he could ask for the work to stop if it became too intense or invasive for him. This gave him not only a sense of control, but a project -- paying attention. When the boy returned for the second session the following week, he told Bolesky he'd not been in any fights all week.

The sessions continued until after the fourth week when the 8-year-old boy informed Bolesky that he would "get better by myself now." Regard-less that this broke protocol, and that with most other clients she would argue the case, Bolesky let the child guide her work and agreed with his decision. The patterns of children aren't so "hard-wired," Bolesky says, hence they are much easier to "fix." Now in high school, the boy is no longer plagued with either the stigma or symptoms of ADHD. He did continue to get better by himself as he predicted.

Bolesky explains his success: "My assessment is that when he surrendered control of the left hemisphere and felt his core brain (the part of the Three- Brain Model that governs where we experience bodily sensation and energy), he was reminded that his body was a safe place."11 The child's mother reported that was indeed the case as her son became aware of his behavior, learned how to control it, and recognized his feelings after working with Bolesky.


Parent-Approved
Just recently, several parents had a chance to offer feedback on the work Bolesky has done with their children. The responses were overwhelmingly in favor of recommending Soma to other families dealing with ADHD. Following are a few of the individual comments.

By his mother's account, "Cole" was a serious, hypervigilant child when he came to Bolesky in 1996 at the age of 8. "I never heard him laugh," this mother recalls, explaining the struggles the family was experiencing at the time as they dealt with an alcoholic, drug-dependent father/husband who had abandoned them three years earlier. After working with Bolesky, the mother writes that her son was transformed.

"His body is so beautiful and balanced now, and he is a highly skilled athlete," she says. "We've had nothing but positive results. Soma has made a tremendous difference in my son's life."

In 1997, 9-year-old "Jason" came to Bolesky for help in working with his stressed emotional behavior and overreactive nature. Jason had an advantage coming in -- his father was a touch practitioner -- which allowed him the ability to slip easily and immediately into the work.

"This child responds openly and deeply to touch and did so during the Soma sessions," Jason's father says. "The response was occasionally profound -- coccyx work elicited weeping, while the psoas work prompted laughter."

In addition to a greater sense of openness with his parents, Jason was reported to be calmer after the Soma work. He also exhibited greater communication skills at home, developed a stronger connection with his father, had more ease and grace athletically, and developed a sense of self and leadership skills.

"Soma allowed Jason to be clearer about himself and his needs."


In the End
Integration is a key factor to health, especially when you think of the divisive nature of ADHD. What better method of treatment than a structural approach like Soma Neuromuscular Integration that allows for the unification of body, mind, and spirit? It opens the door of thought: Might this not work for something even more insidious, such as bipolar disorder, manic depression, or even autism? The possibilities certainly exist, and like the healing work of so many body therapies, who knows what roads they might take us down next.

Karrie Osborn is contributing editor of Massage Bodywork magazine.



References
1 Hancock, L. Mother's little helper. Newsweek, March 18, 1996;51-56.
2 Gordon, J. Attention Deficit Disorder, www.drjaygordon.com/alternative/add.htm. Accessed February 2004.
3 Hoza, B., Pelham, W. E., Sams, S. E., Carlson, Caryn. An examination of the "dosage" effects of both behavior therapy and methylphenidate on the classroom performance of two ADD/ADHD children. Behavior Modification, 1992, April;16: 164-191.
4 Ibid.
5 Barkley, R. A. Taking Charge Of ADHD, New York: The Guilford Press, 1995.
6 Ibid.
7 Hynd, G.W., Lorys, A. R., Semrud-Clikeman, M., Novey, E.D., Eliopulos, D., Lyytinen, H. Corpus callosum morphology in attention deficit-hyperactivity disorder: morphometric analysis of MRI. Journal of Learning Disabilities, 1991;24:141-145.
8 Medline Plus, Attention Deficit Hyperactivity Disorder. www.nlm.nih.gov/medlineplus/ency/article/001551.htm. Accessed February 2004.
9 Gordon, J. Attention Deficit Disorder, www.drjaygordon.com/alternative/add.htm. Accessed February 2004.
10 Caroll, Lee and Tober, Jan. The Indigo Children, Hay House Inc., 1999:196.
11 Ibid., 194.






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