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mikeb
06-02-2005, 06:52 AM
Dr Lam,
I am a friend of Ralph Dehner. He practices Tai Chi in Cincinnati. I am a beginner and have learned the 6 forms and soon to get the 24 forms tape. I am a mental health/drug and alcoholism counselor. My question is regarding whether Tai Chi benefits persons with serious mental disorders such as schizophreia, Bipolar Disorder, Depression and addictions.
Thankyou.

soraya
06-02-2005, 09:17 AM
Mike

I have been teaching Tai Chi in a clinic for psychosomatic medicine. From my experience it cannot replace medication, proper counselling, specialized psychotherapy and group therapy but esp. with the younger patients I saw a clear improvement in their anxiety or sometimes depressive conditions after Tai Chi lessons. Moving Tai Chi is better in this case than static qi gong. Sometimes when the patient is not ready, the stillness in static qi gong may cause a flow of uncontrolled thoughts.

Bill and Richard Livingston are good Tai Chi players and psychotherapy professionals, so pls. wait for their advice. I am not a psychiatrist but I collaborated with psychiatrists, psychologists and physical therapists.

carolinew
06-02-2005, 10:23 AM
I.m not a health care professional, but have seen the positive effects tai chi has on my friends special needs children. As I am not a teacher, I keep things informal, and there is a possitive effect in the terms of improved behaviour and better concentration.

I do agree with Soraya, it is better to wait for the right people to reply, but thought personal experience might help.

BillT
06-02-2005, 10:34 AM
Mike-

This is a topic I love. Briefly, Tai Chi benefits people with all sorts of mental illnesses and addictions, but does not make much of an impact on the core syndromes except perhaps for depression or anxiety. It likely helps people with anxiety disorders and depression more than people with Schizophrenia, Bipolar (Manic Depressive) Disorder, or addictions.

For several years I have provided group therapy in a dual diagnosis (mental illness and substance abuse) day hospital, as well as other services on an inpatient service. Frequently, my Tuesday and Thursday afternoon sessions have been Tai Chi, although I promote it for relaxation, "and other positive results," rather than claiming it will cure illnesses. We use Dr. Lam's 6 Yang style forms because it is easy to learn in a few sessions, the patients can buy the disk or tape locally, and it is a good gateway to the ubiquitous 24 forms.

People with anxiety disorders and depression generally report good results, and like the sessions. Many have bought the tape or disk, and several have asked for help connecting to a club or school. A biasing factor is that these patients receive a variety of therapies, but the fact that they like and single out the Tai Chi makes me believe it is helpful. A second reason I believe it is helpful relates to the Cognitive theory of depression as espoused by Aaron Beck ( http://www.beckinstitute.org ) and others. In short, having successful and positive experiences, gaining skills, and doing positive things for yourself like Tai Chi helps overturn the biased perceptions of people with depression and anxiety. The movement gives people an outlet for their physical restlessness as well.

My patients with Schizophrenia or Mania are often too disorganized to engage. I would like to try with a group who are a little less acutely ill.

Many of my patients with substance abuse disorders (mostly opiates, or polysubstance dependence) are unenthusiastic about Tai Chi. Many report chronic pain, and feelings of lack of control, but cannot be "sold" on learning a coping skill rather than having some external agent deal with their condition. A few have liked and used the Tai Chi. I always offer it, and if only a few benefit, that's still better than not offering Tai Chi.

A lack of time keeps me from offering Tai Chi to more than a few very highly selected inpatients. We do have a Yoga instructor here in our inpatient service every Friday, and her classes are quite popular. I think Tai Chi would be similarly appreciated if I could take the time to present it as a structured part of the program.

Finally, Tai Chi helps ME cope with the anxiety, depression, Schizophrenia-like state, and manic-depressive state that seems to threaten to besiege my psyche when I get to work and find the line of patients waiting to see me! I often sneak into an empty conference room for a few minutes to run through part of the Yang long form, or to do some similar qiqong such as practicing a Bagua Snake change.

Good Luck, Bill T.

soraya
06-02-2005, 02:05 PM
Bill

I have a student whose husband is manic. She has similar psychological conditions like you described yourself before seeing your patients with mental disorders. Obviously living with her husband has affected her psyche very much and these people very often need support themselves. She is currently receiving counselling from a qualified psychologist and does Tai Chi with me. Her husband feels that his condition becomes more balanced and he gets better control over his manic state.

He is unorganized, although Tai Chi helps him to subjectively feel better and more balanced, it does not change his core symptoms. Just as an example: he is intelligent and academic, speaks many languages and well-travelled but his behaviour is simply disorganized. He gives his mobile phone to a stranger, he leaves his wife, goes to a restaurant while waiting for the plane to come in an hour, forgets totally unless she is going to fetch him. When he is in his depressive state than he either sleeps or totally apathic, unmotivated and unable to perform any intervention incl. Tai Chi

Dr. Paul Lam
06-04-2005, 08:25 AM
thanks for the question and many good answers.

in principles i agree tai chi helps, but many psy conditions require multi-disciplinary approaches. hope this helps... will try a longer answer when i get home or if you still not satisfy with all answers above.

stanton
06-04-2005, 12:17 PM
Lutang was stated to have fits of depression when he was younger but as he got involved in martial activities, it disappeared. Level of psychological problem (mild/moderate/severe) will detemine per the primary care provider's diagnosis along with the subject's ability to comply with the intervention.

If it is too mentally demanding, then compliance is kaput.

Dr. Paul Lam
06-05-2005, 07:00 AM
exercise has been consistently shown to be as effective as the best anti-depressin drug. however i am not aware of a strong tai chi study on depression, i am sure if one can be done it would be shown great positive effect. but be aware there are many psh condition - these conditions should be cared for by a qualified health professional, tai chi can be an complementary therapy but must be directed by health professionals.

there are studies that show tai chi effective in relieving stress.

drlip
06-09-2005, 05:33 PM
Thanks for opening the discussion! Bill's thoughtful reply is superb. BTW, I have sometimes "seduced" younger or more macho substance abusers into trying TCC by emphasizing the martial orgins and applications when introducing the subject. Soraya is on target too, as usual. All these are good ideas, y'all, and thanks.

Also of interest: many of the standard techniques taught to mental health workers for managing violent or threatening patients have obvious (to me anyway) TCC orgins.

Please leave this thread open a while--I may think of something more useful to contribute...

Richard Livingston, MD

drlip
06-09-2005, 10:41 PM
Thinking a bit more, I believe TCC will be of particular help as part of a comprehensive treatment program for some of these folks:

depressed people who have been inactive and need a good way to begin being physically active again

anxious and fretful people who need to learn to relax and redirect their energy and attention

people whose psych meds help their symptoms but cause lethargy, increased appetite/weight gain, or that "zoned out" feeling

people who can think and solve problems best when they are moving and need therapeutic movement that can become near-automatic

people who need some focus and direction but nothing too complex at first

people whose pain has made them feel helpless and dependent and who do not like that

people who need to work on breathing, balance, coordination, in a simple way they can practice on their own (e.g., early in dementia)

plus, it would not surprise me if it turns out to be especially helpful in Parkinson's (idiopathic or medication-induced), moderate to severe Tourette's, other movement disorders.

Richard Livingston, MD