April 6, 2018 at 1:53 p.m.

Car steered Alzheimer's thesis


By KATE BLAIN- | Comments: 0 | Leave a comment

For Rev. John Malecki, a white Oldsmobile Toronado led the way to new discoveries about people with Alzheimer's disease.

The staff psychologist for the diocesan Consultation Center was working toward a doctorate from the Jung Institute in Boston when he was asked to do pastoral counseling with patients with Alzheimer's at Teresian House Nursing Home in Albany.

"She's sort of helpless, and there isn't much you can do, but at least be kind," the first patient's doctor remarked.

In a recent interview, Father Malecki admitted that initially, "I bought into that. I was a condescending listener."

Listen to soul

The patient, "Mary," often spoke of how she missed her white Toronado, the car she'd owned before she entered the nursing home. Father Malecki reminded her over and over that it was no longer safe for her to drive.

One day, Mary pounded on the table in frustration. "You are not listening to my soul!" she told the psychologist.

Father Malecki said he was taken aback -- then realized she was right. "I learned to go where she's going," to follow her train of thought rather than imposing his own, he explained. In the process, he realized that Mary hadn't really been talking about losing her car, but her freedom.

With someone finally understanding her way of expressing herself, "in three or four months, her depression totally lifted," the psychologist said. "That gave rise to the thesis."

Research

Father Malecki decided to do his doctoral thesis on patients with Alzheimer's disease. In light of his experiences, he hoped to answer four questions:

* What are the images from their unconscious?

* Are they capable of symbolic thinking?

* Are they capable of giving meaning to their suffering?

* If so, then what kind of a spiritual life can they have?

He told The Evangelist that no one had explored such ideas before. "I knew I was onto something groundbreaking," he stated.

With the permission of Sisters Pauline Brecanier and Eileen Fitzsimmons, O.Carm. (respectively, Teresian House's administrator and coordinator), Father Malecki gathered a group of 12 patients with early- and middle-stage Alzheimer's disease and began to do therapy with them.

Drawing on life

"One way to get images from the unconscious is to use drawings," he noted, so he asked the group to draw at each session. He also used Bible parables and classic folk tales to spark their unconscious.

The results amazed him. For one thing, the group developed favorite stories -- including the parable of the Prodigal Son -- that they clamored for again and again.

But they not only enjoyed the stories; they also understood the symbolism behind them. When Father Malecki read a folktale about God helping people to dig up mountains, the group said, "The mountains are like our illness."

"Throughout the entire session, they were able to maintain discourse at the symbolic level," Father Malecki said.

Images

The patients' drawings also surprised him. Although the group knew their diagnosis, they drew "images of hope, beauty, vitality, immortality and new beginnings. That springs from their souls," the psychologist said.

One patient's first drawing was of a red dog with a human head. "The symbolism is almost self-evident: `I'm in trouble, and I need someone to talk to,'" said Father Malecki. He asked the woman what troubled her, and she said she hadn't spoken to her daughter in 30 years.

Father Malecki arranged a meeting of reconciliation. After it, the woman drew an androgynous figure, which the psychologist said is usually a symbol of Christ. Two days later, the patient passed away.

Another level

The psychologist found that the patients were operating in "primary process" -- basically, that as their cognitive deficits increased, their unconscious took over, and they operated by instinct.

One example occurred when a patient had an attack during a group therapy session. As Father Malecki waited for the ambulance, he asked, "How do you want the group to help you?"

"Would you ask them to pray for me? Tell them I'm scared," the man replied.

Hearing this, one of the group told the suffering man, "When I'm scared, I feel like my relationship with God is what the relationship of my body is to gravity. God is just there."

The exchange illustrated one of Father Malecki's findings: that patients with Alzheimer's seldom say, "I believe in God." Instead, they're more apt to say, "I know there's God."

Depression

Through the months of therapy sessions, the psychologist measured the group's depression levels with the Beck depression scale. He found marked improvement and said that several of the 12 patients eventually died "with great peace."

Father Malecki concluded that he'd answered his questions in the affirmative: Alzheimer's patients can indeed think symbolically and give meaning to their suffering; they can express images of joy and hope despite their illness; and they can have a relationship with God.

Alzheimer's disease "is not the dark passage that medicine makes it out to be," he stated. "The cognitive deficits in Alzheimer's patients are due to dying brain cells; that's obvious. But there's a learned passivity due to the way the medical and social community treats these people. I have hard research to back that."

Hopes

The psychologist successfully completed his doctorate, and has since spoken to several groups of medical professionals about his findings.

"What I hope it leads to is an acknowledgement that these people aren't to be treated with condescension -- to treat Alzheimer's patients as persons," he said. "Many relatives and medical personnel are unaware how, unconsciously, they treat them as inadequate."

Father Malecki spoke of a book, "Elegy for Iris," in which the author, John Bailey, tells how he cared for his wife when she had Alzheimer's. When she jumped out of a car to run through a field, he would join her rather than scolding her. After two years, rather than being worn out, he was energized.

In the same way, Father Malecki (who is 79 himself) said he came away energized after his sessions with patients with Alzheimer's.

Changes needed

The priest said he'd like to see several changes in the treatment of such patients as a result of his thesis: "that they be treated as persons who have an illness, that we learn to communicate with them, that we acknowledge they're capable of symbolic thinking, and that we recognize they're praying (when they're in primary process) instead of [using] restraints.

"It's astonishing how differently we would treat people if we don't see them as helpless," he remarked.

While the psychologist said working toward a cure for Alzheimer's is laudable, he said he'd rather have relatives stop saying things like "I've lost my mother" when they hear the diagnosis.

"You're missing an opportunity to know your mother in a way that's better than ever," he said.

Father Malecki's thesis is complete, but his work is not. He continues his therapy sessions with patients in Teresian House's Alzheimer's wing.

"As long as I have health and Teresian House permits me, my intent is to keep learning with them," he stated.

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