COMA: A HEALING JOURNEY

A process-oriented perspective adopted by ComaCARE

Process oriented coma work Current medical approach Coma is still to be fully understood

Process oriented coma work

Arnold Mindell, founder of Process Oriented Psychology, also known as process work, has pioneered a caring and sensitive approach to the experience of coma. In his foreword to the book, Coma a Healing Journey[1]written by his life and work partner Amy, he states:

“Until now, approaches to coma that we know of, including medical and non medical treatments, have emphasized shocking, pinching and other kinds of aggressive or noxious stimulation based on the pathological model; the person in a comatose state must adapt and return to everyday reality.

While process work does not deny the potential usefulness of such approaches, they seem unnecessarily violent. Instead coma work is based on the philosophy that the human being in coma is on an inner journey, dealing with that coma in the best way nature knows how. Therefore our entire effort is devoted to meeting individuals where they are, in that deepest, almost unfathomable, altered state of consciousness.

In other words, instead of arresting the coma state, we encourage and join the comatose person in exploring that journey. In this way the comatose person has a chance of feeling related to. Empathy with that state results in heightened communication potential and, occasionally, awesome insights and contact.That’s our goal; to assist the person in coma either to direct or, at least take part in her or his healing programme."

See links to training for carers and How we work.
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Current Medical Approach
Today, coma is understood medically as, “A state much like sleep in which patients are completely unarousable and are unresponsive to external stimulation and their own inner needs."[2]

Comas can be classified into the following broad categories:

• Comas attributable to structural or mechanical injury, disease or poisoning.
• Comas resulting from metabolic changes occurring near death or from insulin imbalances.
• Comas with associated psychogenic or psychological factors that contribute to the comatose state.
• Comas caused by a combination of the previous three points.

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Coma is still to be fully understood
Popular interest in coma has risen recently with the case of Terry Schiavo, whose feeding tubes were removed after fifteen years and an embittered battle between her husband and her parents as to whom had the right to determine her life. She died after thirteen days. In the eighties, Karen Anne Quinlan had her life support removed and remained in a vegetative state for nine years. Journalist Mary Kay Blakely, in her popular book, “Wake Me when it’s Over” described her experiences in and her emergence from a diabetic coma.

A former editor of Elle magazine who suffered a stroke emerged from his coma unable to communicate verbally. In his physically 'locked in state', he dictated an entire book about his experiences through blinks of an eyelid.[3]

In May 2005 a young man awoke after ten years in coma and asked for his wife and children. Clearly coma and altered states of consciousness are not fully understood and must be treated with a great deal of respect.

A further discussion of the definition of coma and vegetative states is in Coma definitions and International research.

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[1]Amy Mindell. [Coma, a Healing Journey; a Guide for Family Friends and Helpers].
1999 Lao Tse Press.
[2] American Medical association Encyclopedia of Medicine.
[3] Jean Dominique-Bauby, [s], Vintage 1998.

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