From Sock Puppets to Psychotherapy

Derek is an 82-year-old man with symptoms of post-polio syndrome. Post-polio syndrome tends to develop decades after the childhood onset of illness, and can include progression of joint stiffness and pain, and muscle wasting, and fatigue. He currently resides in a nursing home where I meet with him for psychotherapy.

He uses a wheelchair, and a slide board to transfer from bed to chair or chair to toilet.

Derek has a chip on his shoulder the size of a woodpile. He is generously kind to those he feels are respectful towards him, and verbally lacerating to anyone he considers to be rude or neglectful to him. He enjoys and looks forward to weekly therapy sessions, and he has been able to openly share and discuss private emotions and personal concerns long held in check.

He is intelligent and articulate, and a keen observer of others. He works diligently in physical therapy with the goal of returning home with support services. He exercises daily in his room with stretchy rubber strips seeking to ease some of the agonizing ache and stiffness in his legs.

He grew up on a hospital unit for children with polio. The Dickensian hospital environment he has described was deeply traumatizing for him. Being at a nursing home under the care and authority of others triggers trauma associations to the long-ago hospital setting and evokes a defiant and argumentative defensive style of interacting with some of his care givers.

Derek describes a nearly military style attitude of tough love by his childhood care givers on the polio unit.

‘They did not use sympathy with us, they believed that if we weren’t tough, we would never survive,’ Derek said. ‘If you fell down they would say – “get up!” – they knew we needed to learn to get ourselves up on our own. I didn’t like it at the time, but looking back I think they were probably right,’ he said.

Derek spoke of a long hallway of iron lungs on either side. ‘I was terrified of the iron lungs, all us kids were, and we saw how so many kids that went into an iron lung didn’t come out alive. I can still remember the awful sound of all those compressors! They would give us a device to blow into to see if we needed to go into the iron lung, and I never tried harder at anything than to make that little blue ball go up to the right number.’

‘When I was 10 years old, I was physically tiny because my legs were so wasted. I was in a room with five other boys. I could hide from the adults by curling up under the sheet at the foot of my bed and they wouldn’t find me.’

‘One day they gave us some sock puppets to play with. The puppets had animal faces. I used to put one puppet on each hand, and I would talk to the puppets, and they would talk back to me and to the other boys. Through the hand puppets I could tell the truth; I could tell what was true for me and for the other boys; I could tell the truth of how we were feeling. We couldn’t really tell the adults how we felt, so I used the puppets to say what each of us felt but couldn’t otherwise say.’

Derek feels like he is in a race against time. He hopes to be well enough to return home, and to receive adequate home-based support services so he might be reasonably stable and well, at least for a while, yet he dreads the advancement of age and illness.

‘I don’t want to die, but I know I could die at any time,’ Derek said.

‘One thing that all of us polio kids share is a strong determination to fight on and never give up, and that’s just what I intend to do, as long as I can,’ he said.

In therapy, Derek has shared his secrets and his sorrows, and I have shared my admiration of his grit and perseverance. Therapy helps him unlatch some of the emotional armor that long helped protect against the frightening and profoundly lonesome hurt of his childhood.

One of the rewards for me, as a psychotherapist, is to witness examples of courage and the triumph of human spirit over some of the adversities encountered in life.

I am honored by the trust shown by Derek in openly sharing and discussing secret things he otherwise had not talked about. I see how much he has suffered from childhood to the present, and also the many clever strategies he has acquired and practiced in his life.