A therapy program that resulted in Chintan losing his job as a caregiver.
Schizophrenia is one of the major mental illnesses. There are many variations of the affliction. Typically, the schizophrenic is a little odd. He or she may hear voices and/or see things that we “normal” people agree are not there. Their appearance is often a bit bizarre, their clothing not quite standard issue, and their general appearance often leaves much to be desired. Many have difficulty making direct eye contact. In modern-day America, the majority of those afflicted with the dis-ease are heavily medicated, which effectively mutes the auditory and visual hallucinations, but also negatively affects their primal energy and cognitive abilities.
Institutionalized humans labeled as Schizophrenic, and others suffering from major mental illnesses have recently been released from institutions that confined them for most of the twentieth century, and have been placed in group homes and residential care facilities. Aided by modern pharmaceuticals, their symptoms controlled, and no longer subjected to lobotomy, electroshock and restraints, these damaged human beings exist within our society, some living right next door, enjoying semi-normal lives, assisted by a team of psychiatrists, psychologists, social workers, nurses and mental health workers.
Basketball is one of the major sports. Dr. James Naismith, a college professor from Massachusetts, invented it more than a hundred years ago. From its humble origins, it has grown to international prominence, and is played at every level, from grade school to professional competition. Ideally, it is played by 10 individuals, five on each team.
Basketball is the ultimate team game in my opinion. When played correctly, it is a thing of beauty to behold, and a joy to play. It is a game in which the inflated egos are soon crushed, an arena where the selfish are soon identified and defeated, because although a dominant player can amass a large point total, his team is ultimately defeated. The truly great team is one in which all five participants share the ball. They are five individuals who give up the individual ego in order to forge a cooperative and strong society of friends.
Schizophrenics, living in group homes and residential care facilities, arise each morning in the darkness of their disease, in a chemically induced fog, in unadorned rooms with shades drawn to keep out the world. The workers are already gearing up for the day, preparing to guide their patients, who are now referred to as residents, consumers or clients, through their day.
For people living in this environment, every day is pretty much the same. There is nothing really to do. They are processed through the day with something called ADLs (Assisted Daily Living). The ADLs consist of showering, medications, meals, and medical appointments, and, in some cases, therapy groups. The groups are an attempt to normalize the clients, to give them the skills necessary to reenter society. There are computer groups, exercise groups, art groups, and a host of others.
Most clients decline participation. Staff members expend a great deal of energy trying to convince them to join, but due to state regulations, are powerless to force the clients to do anything. Some clients even refuse the basic necessities of life, such as eating healthy meals, taking showers, putting on clean clothes. Some clients go for weeks without bathing or changing their clothing. Refusing medication, even though it is a right, is not usually a problem. If the client refuses for more than a day or two, the system goes into high gear, and the client finds himself gently escorted back to the asylum.
The two come together
Basketball hoops exist on the property of some of the group homes. Used mostly by staff, occasionally one of the clients can be coerced into shooting a few hoops in between cigarettes.
David, Arthur, Bryan, Nelson, Wayne and Mathew live in one of the group homes. It is 8 in the morning, a beautiful sunny June day. The staff have brewed the coffee and are in the process of pouring the medications.
A Day in the Life: Nelson has been awake for over an hour, and has spent the time sitting in a chair rocking back and forth, waiting for the meds to be dispensed so that he can receive his morning cigarette allotment. Nelson is under guardianship of the Department of Human Services. His guardian and doctor have placed him on a cigarette-rationing program in an effort to save his life. Forty-Five-year-old Nelson has been institutionalized since the age of 17. He is considered to be schizophrenic, borderline mentally retarded, and has serious health issues brought on by a life of inactivity, bad diet, and smoking; not to mention a lifetime of ingesting psychotropic drugs.
David and Arthur slouch into the kitchen, pour glasses of water, and wait passively for their cup of pills. Both are young 40-year-olds, both intelligent, both darkly depressed and isolated. Although they have known each other for years, and are even considered to be friends, they stand silently apart, not looking at each other.
“You must be really rich to afford shoes like that!” David has made the statement to the staff. The staff is used to David making bizarre statements, and lets it float by unanswered. “Yeah, they must be really expensive.” David’s second comment is answered with a curt “Yeah, most expensive shoes in the world,” as the staff passes David the med cup. David, as is his habit, turns his back, looks at the pills, and then slowly and reluctantly, swallows them.
When Arthur’s pills are ready, he steps forward two paces, takes the pill cup and, without a glance, pops them into his mouth. “Can I have my cigarettes now?” asks Arthur.
Mathew and Bryan, having been prodded out of bed by the second staff person, amble into the room, take their pills and return to bed.
Wayne is the last to arrive. He moves his hulking 370-plus pounds into the kitchen, surveys the scene, and with a flourish announces, “Beware of baby snatchers!” Wayne is really gone, out to lunch, over the edge. He is the textbook schizophrenic, complete with bizarre dress, bizarre ideas and bizarre statements. His pill cup this morning contains six pills. At intervals throughout the day, he will receive four more. At 8pm he will be given the final 13 of the day.
Of the six patients, only Bryan sits down for breakfast. The rest are too anxious to ingest the first cups of coffee, and smoke the first few cigarettes. At lunch they eat whatever is available. In the evening the staff prepares dinner; the only balanced meal they consume each day.
This is their life – meds, meals, cigarettes, coffee, TV and avoiding the staff. The life force is barely present. Their response to most questions is “NO!”
The dream team
Magic Johnson receives the ball from in-bounding teammate Michael Jordan, and skillfully dribbles the ball over the half-court line. He spins around one defender, and looking left, throws a bullet-pass to a cutting-to-the-hoop Larry Bird. Larry catches the ball at chest level, elevates for a jump shot as two defenders leap into the air to defend. At the last second, still airborne, Bird spies Clyde Drexler standing inches behind the 3-point line, and throws a perfect pass to Clyde. With the entire opposition surrounding Magic and Bird, Clyde calmly launches a high arching shot that nestles ever so smoothly in the net. With high-fives all around, the dream team retreats to defend their territory, as the opposing team collect themselves and prepare their attack.
These visions appear in the heads of basketball fanatics as we, not so artfully, drive to the hoop, launch the last-second desperation shot, throw the no-look pass, or dribble the ball through a crowd of defenders.
The idea dawns
A couple of years ago, as I shot a few hoops outside the Brentwood Group Home for the Mentally Ill, those visions were undoubtedly swimming around in my consciousness, along with the myriad other thoughts that vie for attention. Along with those thoughts, both sublime and ridiculous, was the awareness that I was alone on the court, being witnessed by a few of the clients, who were sitting on the porch, smoking their cigarettes, avoiding me, avoiding each other… avoiding life.
“Hey, put out those butts and get YOUR butts out here. Are you going to let an old man like me play basketball while you smoke yourselves to death?” I was probably violating at least 20 paragraphs of government regulations designed to protect the mentally ill from abuse, but these guys knew me, knew that I cared, knew that I wouldn’t hurt them.
Slowly, reluctantly, painfully, two of them walked zombie-like to the tiny asphalt court, and we proceeded to play. Nelson insisted on shooting only 3-pointers from the trashcan located 70 feet away. Much to my amazement, after a couple of attempts, he managed to score two in a row, then walked off the court, huffing and puffing, and reaching for a cigarette. David and I played one on one for about three minutes, and then he too retreated to the world of nicotine.
It was a beginning!
The dream(ing) team
Basketball plus Schizophrenia equals – what?
What would it be like to gather these men, and guide them onto a basketball court? This was the question that wouldn’t let me go. It haunted me. It intrigued me. Could it be done? What would it look like, feel like? The main image that came to mind was the scene from the film One Flew Over the Cuckoos Nest where Jack Nicholson vainly attempts to get one of the patients to throw the ball to the REAL people.
I persisted. They resisted.
Other staff laughed at the absurd notion that these clients, these severely limited mental patients could possibly form a basketball team. The thing that kept me focused on the goal was my very strong belief that there are no incurable illnesses. This is not a popular notion in American culture. Fortunately for me, I’ve managed to step outside this culture, and was privileged to witness what would be termed miraculous healings first hand.
Bryan was one of the first clients who showed genuine enthusiasm. “Yeah, I’d love to give it a try. I’m not very good though.”
We began in early spring. A fellow staff person and I managed to get Bruce and David to join Bryan on the courts. We played for only a few minutes at a time. Bruce became thoroughly depressed after missing his first shot. With encouragement, he remained on the court and finally was able to put the ball in the hoop a few times. Even with this success, he seemed thoroughly depressed. Bryan, on the other hand, had a great start, making a good percentage of his 3-point shots. His entire game consisted of receiving the ball, and immediately launching a shot. Passing, dribbling and defense were foreign concepts.
Throughout the summer we met each Friday morning at an outdoor court. Word of our group spread through the agency and we were soon joined by a few others; some staff, some clients. By the end of the warm season, we had nine fairly committed individuals. I managed to work out a deal with the local community center, and as the cold weather approached, we moved inside to a real gym, a real basketball court.
As the team began to take shape, we initially had to deal with the emotions that such a venture stirs up. Here were men suffering from severe mental illness, used to a sedentary and solitary lifestyle, suddenly thrown into a world where eye contact, communication, and deep breathing were essential.
Bruce’s horrible self-image, coupled with his seemingly constant state of anger was an obstacle that none of us could overcome, and after a few months he dropped out. Bryan also had a hellish time. As we encouraged him to try something other than 3-point shots, he invariably felt our words to be stinging rebukes, more shame and embarrassment to add to the stockpile of assaults he had already endured in life.
I found myself playing entire games focused almost exclusively on him, encouraging his every success and counseling his teammates to keep their criticisms to themselves. It took forever, but eventually Bryan began to add new skills to his game. Even with all the encouragement, it wouldn’t take much to deflate him, and quite often he would stop in the middle of the game, grab his things and walk off the court, muttering that we would never see him again. But, each week he would return, and each week he got stronger and stronger, more skilled in the game, and more emotionally stable.
As the level of play increased, so did the possibilities of injury, both physical and emotional. With each bruise or shouted encouragement, Bryan would, with shoulders raised and eyes lowered, stomp off the court, with me in hot pursuit.
Bryan was a great gift for me. I have always had problems with patience; solve a problem quickly and move on to the next one. With Bryan, I was learning the patience of the saints. At first, none of the interventions worked. No matter what I said, Bryan was huddled inside, seemingly oblivious of the outside world.
Off he would go.
The following week he would return, stating that he didn’t know what had happened and that he really loved basketball and would not leave again. I, in turn, would heartily welcome him back. Then it would happen again; banged by another player, or insulted by a teammate’s encouragement, and off he would go.
The turning point occurred during a summer practice session. Off he went, with me in very hot pursuit. Out of earshot of the rest of the guys, I stood in front of him, and in a stream of consciousness outpouring, told him in no uncertain terms that I felt he was an extraordinarily sensitive, talented young man who had a great chance to move on with his life, and that he was throwing it all away by allowing himself to be put down, both by forces on the outside and by that voice or voices in his head.
The words, coupled with the intensity of the delivery had a profound effect. With tears in his eyes, he related a lifetime of put downs, and a feeling of rage in his belly that frightened him. “I want to be a good person and not hurt anyone, but when I get hit, I feel like I could kill someone.” I counseled him that he was not alone in that feeling, but it was just a feeling, and that rather than hold all that rage inside, there were other avenues of expressing that rage and turning it into constructive energy.
He returned to the court and played the best basketball of his life.
Since that time, he has had his glasses knocked off by an overzealous defender, been hit by the ball in the stomach numerous times, had his finger bent back, and has been scolded by me a dozen times for screwing up a play. Instead of stomping off the court, he has rebounded from the rebukes with an increased level of play.
Arthur and David also had extreme emotional reactions to the game. The staff people had to begin early Friday morning with their words of encouragement. They showed up for the games, but invariably with the look of condemned men on the way to the gallows.
Arthur tried to escape by pulling the covers over his head in his darkened room, and pretending to sleep when I picked him up for the games. It was only through patience and persistence that he finally, reluctantly left his room. Once on the court, the energy of the game would take over, and both men would be lifted up and out of their depressed state, smiles creeping in to dispel the frowns.
Three years into this experiment, we have become a team. Through the generosity of many friends and colleagues, money was raised to purchase uniforms and pay the rental fee at the community center. We have overcome emotional and physical barriers to make this team a reality. It is an on-going battle. There is rarely a Friday morning where there isn’t at least half a dozen obstacles to overcome. Clients become too depressed to drag themselves out of bed. The aging staff gets sick. Communication glitches abound. And yet, we continue.
We have reached a new plateau. Even with all the obstacles, on almost every Friday morning, 10 guys show up at 10am ready to play. Once play begins, there ceases to be staff and clients. There are only men playing basketball. We have established a fan base of a dozen people who are wildly enthusiastic. A few of them are becoming formal with their cheerleading, and perhaps we will soon be in the market for cheerleading outfits.
Not just a dream
During a recent five-on-five game, with the audience wildly cheering us on, it became apparent to all that we had indeed become a legitimate team. Bryan, who at one time had only the 3-point shot, now was mastering the point guard position. Rather than standing around waiting for a chance to shoot, he was dribbling the ball up the floor, waiting for the opposition to challenge him, and then making the decision whether to pass or shoot. Ronald, who at the beginning of our group spent most of his time talking delusional nonsense, and seldom being attentive to the real world, was now moving silently and strongly towards the basket. Joel, our most dedicated staff person who attends each and every game, eludes his defender, makes eye contact with Bryan, and signals for the ball. Bryan immediately chooses the pass option, and throws a perfect pass to Joel, who relays the ball to Ronald who is in perfect position underneath the basket.
The shot is up and it is good.
Schizophrenia and basketball
Who would have thought that this marriage could take place? What does it mean? What is going on here? It has become second nature to me after three years of slowly creating this group, but as I sit here writing, it dawns on me that this is not supposed to happen. It was generally thought that these men were condemned by their illness to slowly deteriorate. They were not supposed to become basketball stars. They were not supposed to show up for an event in which they are the focus. They were not supposed to be cheered and appreciated.
Perhaps it is a product of my own delusional system, but I’m imagining that this is only a few steps into the total program, and that at the summit is, dare I say – Total Recovery.
Although I cannot claim to be an expert authority on schizophrenia, I do know that diagnosed schizophrenics are for an hour and a half on Friday mornings engaging in a real world, high-energy activity that requires awareness, focus, intelligence, athleticism, eye contact and intuition. Where is the dis-ease during that hour and a half? Could a cure for this dreaded dis-ease be as simple as deep breathing, sweating, laughter, pushing the physical barriers, applause, endorphins released, labels dropped, physical touch, emotional roller coaster rides, and perhaps most important, giving the clients an opportunity to be out of their minds.
The term out of his mind has been used to describe a madman, but my understanding is that the madmen I deal with are too much IN their minds; tortured by their minds. The madness I see is a condition of being too much in the mind. There is too much empty time, with nothing to do but think, remember, regret and repeat the personal litany of fears and phobias.
The game of basketball is a joyous opportunity to truly get out of the mind. There is no time for thought. There is only time for action, spontaneous movement – no time to ponder a situation, only time to respond.
My prediction is that one day the mentally ill will have other treatment options readily available. Our society will develop the tools to look deeply into the individual to see if their condition warrants treatment, and be equipped to provide appropriate, natural treatments. In my own life, I’ve experienced other treatment modalities. I’ve witnessed firsthand other avenues of healing. I’ve also seen that the oddball is not necessarily ill. The oddball is perhaps a visionary in his own right.
I look forward to the days to come. In the meantime, we have Basketball!!!
A sad ending, but hope prevails
Well, I hate to end on a sour note, however the basketball program was eventually crushed by an agency too limited by its own fears and phobias. I fought a little too passionately to keep the program alive, and was soon fired. The clients still talk of the good old days when basketball was the highlight of their week. I’m still involved marginally in their lives, although my visits are of short duration, and are becoming less frequent. Some of them come to town with me for a cup of coffee, but none have accepted a basketball challenge. They are getting older, more dulled by the drugs, and with no exercise, fat is replacing the few muscles that our basketball team helped produce.
For the patients, I can’t say this has been a failure. Whatever happens to them cannot negate those magic moments of our dream team, and I’m sure that in each of their inner worlds there is a space in which they are moving in harmony with their team, defending, blocking, signaling for a pass, dribbling effortlessly to the top of the key, stopping, launching that last second miracle, and bathing in the cheers of teammates and appreciative on-lookers as the ball ever so gently swishes to the bottom of the net!