Memory and the Body (Part II)

As an umbrella term including all age related cognitive impairments, dementia in industrial and developing countries is epidemic. The number of cases of dementia worldwide in 2010 was estimated at 35.6 million.(1) Rates increase significantly with age, with dementia affecting 5% of the population older than 65 and 20–40% of those older than 85. (2)  While western medicine is trying to figure out the "cure" and management for this condition, it also would be useful to understand and explore the energetics and the relationship of the culture at-large to this malady.

In science terms, what is happening to those experiencing some form of dementia?  This is a neurological disease, meaning that the neurons and the connections in the body that serve them (synapses, transmission factors) are impaired.  This may be due to an accumulation of protein plaques as part of normal aging, atrophy of vessels effecting subtle communications to the brain, inflammation, inadequate blood sugar, and traumatic brain injury.  In energetic terms, it could be said, there is a block or impingement in the flow of qi or prana:  an energetic (and organic) circulation problem.

We are energetic beings living in layers upon layers of an energy charged world. We are influenced by these layers of energy (universal and material) and we concurrently influence the macrocosmos in how we tend and don't tend our own energy fields.  Life force (the condition of our energy fields, qi, prana) is thinnest at both ends of life's spectrum: infancy and old age.  Because of this, these two populations (as well as the ill) are extremely sensitized to energy.  They are practically osmotic in their internal reception to energy.     They are supremely (non-cognitively) aware of surrounding tensions and are impacted profoundly by even mild (negative, tense) stimulation.  In past posts, when I have mentioned the term "a deeper listening capacity", these populations are living there.  Not out of choice (which would be ours if we choose to nourish that in ourselves) but because their energy fields are thin (or "holey"); there is little to no buffer for them. For most of the rest of us, we have the buffers of ego and personality which usually supersede  these delicate places.  The daily dying we do, the moving in and out of sleep and dream states, straddling these (energy?) "other" worlds are transitions those experiencing dementia obliquely traverse.

For the infant and elderly populations, cognition and reason are not available (not developed yet or disease altered).  Hence, an experience of pain does not always register through the brain's pathways, but is nonetheless energetically experienced.  The sensitized "outsider" looking on would recognize its manifestation as irritability, restlessness, uncharacteristic (negative-based) behaviors.  Between 25% and 50% of older adults experience persistent pain. Seniors with dementia experience the same prevalence of conditions likely to cause pain as the elderly without dementia. Pain is often overlooked in older adults and, when screened for, often poorly assessed, especially among those with dementia since they become incapable of informing others that they're in pain. Beyond the issue of humane care, unrelieved pain has functional implications. Persistent pain can lead to decreased ambulation, depressed mood, sleep disturbances, impaired appetite and exacerbation of cognitive impairment, and pain-related interference with activity is a factor contributing to falls in the elderly. (3)

In the dementia literature, it is stated 40-50% of patients with the illness are depressed.  From my observations, depression and anxiety are prevalent as a past history in these patients.  What's first, the 'chicken or the egg' is the question that comes to me.  From a qi perspective, experiences of anxiety and depression are blocks in the flow of emotional health; it is the plaque in our feeling center that prevents joy, gratitude and acceptance.  Whereas there is an organic, physical/mental atrophy present in dementia progression, considering the flow of qi, life force in our emotional lives is also an imperative.

Finally, one of the things not often considered in the global dementia epidemic, is the place of the larger community.  For those in robust health, entertaining the notion we all are dying a little bit each day, navigating the dying process through dream states, minute loss of one function or another, is difficult to entertain.  As was said, we have the ego and personality buffers that are considerably removed from the truth of momentary dying.  But putting ourselves in the experience of one with cognitive deficits, means to enter that supremely sensitized energy state.  It is possible to straddle the cognitively 'clear' world one lives in while being in a rich and interesting relationship with someone who doesn't have those attributes.  It means listening more deeply, becoming more observant to energy manifestations and intrigued by the being that Is.  It means detaching a bit from what I think is Real.  It means setting aside my preconceived ideas as to what is meaningful and the probable emphasis on rational thought.

1.  Alzheimer's Disease International (2009). World Alzheimer Report 2009. p. 38. Retrieved 11 March 2012.

2.  Sadock, Benjamin James Sadock, Virginia Alcott (2008).Kaplan & Sadock's concise textbook of clinical psychiatry (3rd ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 52. ISBN 978-0-7817-8746-8.

3. Hadjistavropoulos, T et al.; Herr, K; Turk, DC; Fine, PG; Dworkin, RH; Helme, R; Jackson, K; Parmelee, PA et al. (2007). "An interdisciplinary expert consensus statement on assessment of pain in older persons". Clinical Journal of Pain 23 (1 suppl): S1–43. doi:10.1097/AJP.0b013e31802be869. PMID 17179836 

Shega, J; Emanuel, L; Vargish, L; Levine, S.K.; Bursch, H; Herr, K; Karp, J.F.; Weiner, D.K. (2007). "Pain in persons with dementia: complex, common, and challenging". Journal of Pain 8(5): 373–8. doi:10.1016/j.jpain.2007.03.003. PMID 17485039.

Blyth, F; Cumming, M.R.; Mitchell, P; Wang, J.J. (2007). "Pain and falls in older people". European Journal of Pain 11 (5): 

A Right Rest

For most of us, when the need to rest arises, the first choice taken is to lie down or nap/sleep.  The awareness that other types of reprieve are possible if we follow the availability of the body's call, is often unavailable.  This requires a more nuanced listening.

Rest is required when we have expended considerable energy, negativity has created a leak in my energy channels, or the failure to shift my energy through another type of activity (or too much repetition of even a good thing) can be draining.  Sleep is not often the only or best resolution.  Evolving one's own individual care-taking approach is possible.

There I was, wrapping spring rolls for 60 people, about 100 in all.  It was a lovely task:  the beguiling stretchy rice wraps, fresh vibrating herbs and slivered vegetables in interesting layers, ending with a careful tuck .  It was a small motor hand coordinated, delicate operation-- very pleasing to the senses.  About two hours into the task, it became apparent a gear switch was necessary.  A fatigue came over me, my legs had been in one place for hours, my hands in a small repetitive pattern for same.  I picked up a broom and vigorously started to sweep the floor.  I then mopped it with big wide sweeping arcs, a sort of dance that was fully enjoyable, a static containment getting released.

An entire day of large, challenging movement, considerable perspiration in extreme heat conditions, with a concentrated attention to a myriad of tasks --called me to rest.  I took half an hour, went into an air conditioned room and crawled under a large work table. (A vague recollection of spending a lot of pleasure time under tables as a child came to me.) There, I rested on my back, pulled my knees up, rolled side to side, enjoyed some prone stillness, played with my hands and elbows and provided a rolling touch to mostly unrecognized places like ankles, groin, back of legs near buttocks, sacrum, moving and smoothing (energy?) layers of self.  I followed impulses, some surprising, all of them deeply restful. I finished by rolling out from under the table, picking up a water loaded watercolor brush on the table and ran it across a piece of paper, appreciating its movement and action.  I completed the period by adding  a dot of color at the end.  Sublime satisfaction.

Unexpectedly, I spent most of a morning with someone with a consistently mild thread of sarcasm running through their dialogue.  By the end of the morning I was feeling depleted and fatigued.  Realizing, despite my efforts not to let that particular brand of negativity impact me, I had indeed been influenced.  I took a "bathroom break" and instead went out into the drizzle and energetically walked around the block, feeling the hips, femurs in the sockets, my arms swinging up and wherever they felt like going, the cool heavy precipitation dampening my exposed arms.  It wasn't an easy start; the body was halting and apparently in a stuck rhythm at first.  But before long, attention to the way the movement was unfolding and the almost joyous arm swings had me emitting small yelps of pleasure and the shift was made. I did a few chi (energy) baths at the end for good measure.

The common aspects in these different scenarios is awareness of the need for a change in energy and a willingness to let the body play (a type of rest/release any child would attest).  Rest for the weary can be finding play in the heart, mind and body. The right configuration is limitless, it just depends on following the call to where the awareness is leading you. Fingering a delicate branch of a plant, submerging oneself in water and receiving that new impression.  Lying still or allowing fingers to find their expression through another media or their own manifestation.  Sleep is a delicious mode of respite.  But a rightful, authentic rest can be found in our own nature's beckoning if we listen a little closer and respond.