Ask Dr. Barre

[Matthew]

The “standard treatment” for catatonia is benzodiazepine, typically lorazepam, which is meant to enhance GABA production. If that fails, electroconvulsive therapy (ECT), which supposedly has a high success rate. We also want our catatonic family member to do as much therapy as possible to start reconnecting to the world.

1) Is there anything wrong with this approach?

2) What better options might there be?

I have a 30 year old family member who is seriously catatonic and is refusing to do any checkups or therapy. His parents are pursuing guardianship, but want to make sure we have a good playbook one they get it.

The catatonic person in question has been almost entirely secluded to their room at their parents’ home for about 5 years, has slow response times to interaction, difficulty speaking, several behavioral tics, and have in a couple of cases mistaken dreams for reality. Also, they are physically getting very skinny with sunken eyes and cheeks – not critical yet, but might be at that level in 6-12 months. He is religious and believes that he is simply “deep in prayer”. Which he is, but he is also catatonic..

• This discussion was modified 3 months, 2 weeks ago by  Matthew. Reason: clarity

Discussion

[Ari]

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• This reply was modified 3 months, 2 weeks ago by  Ari.
• This reply was modified 3 months, 2 weeks ago by  Ari.
• This reply was modified 3 months, 2 weeks ago by  Ari.
• This reply was modified 3 months, 2 weeks ago by  Ari.

[Matthew]

Hi Ari, looks like your response is blank? Would love to hear your input!

[Erin]

Are you aware of what was happening in your family member’s life prior to him entering this state? Was it a sudden or gradual shift? I believe any therapy you offer him must be done from a place of understanding how he got there in the first place. And not just for your/his caregivers understanding, but for his own understanding so he can return to wholeness. Rather than looking at his symptoms and trying to fix them, can you all shift gears to a place of curiosity and seeking understanding?

In GNM this catatonic state that you describe can be seen as a constellation, meaning he experienced multiple conflicts/traumas all at once that affected different parts of his brain. Was there a situation or event that caused him feelings of extreme anger, fear, isolation, being trapped, powerless, overwhelmed, or unsafe?

Also, the weight loss is a sign that he has likely been stuck in this conflict active phase with his sympathetic nervous system up-regulated for an extended period of time which makes sense given that you said he has been like this for 5 years.

Wishing you and your family member all the best 💗

[Ari]

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[Matthew]

Hi Erin,

Thank you for your very detailed and thoughtful response! Not aware of any trauma but that is always possible.

In 2017 he was in a math PhD program and engaged to a nice girl. He is Catholic, and decided to leave all that behind to become a Benedictine monk. He moved back to his parents’ house temporarily while applying to different monasteries. From there he just gradually retreated into his room more and more and never left home. In around 2021 he began having classic signs of catatonia such as delayed responses and minimal speech. It seems the weight loss has really accelerated since 2023 when I last saw him.

So I view this as more of a slow and gradual decline into depression and then catatonia.
I’m reaching out to our acupuncturist as it seems like this condition could be understood as seriously diminished chi and that proper restimulation of those systems could be a big help.

Agree with your concerns about therapy, and it is tricky with the religious aspect. That is the main reason I always believed him when he said he was ok – thought he might just be having a genuine religious experience. He may be, but he also clearly is catatonic now. Definitely agree that we need to find a therapist who understands and respects this dimension.

• This reply was modified 3 months, 1 week ago by  Matthew. Reason: clarity
• This reply was modified 3 months, 1 week ago by  Matthew. Reason: clarity

[Ari]

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[Matthew]

Alright guys let’s be honest, the lack of responses is very disappointing especially given the name of this channel.

I know this happens to pretty much everyone else who asks an important question here, so just wanted to be frank and call it out. This community or at least this particularly named group needs to do better!

Thank you Erin for your response, and whatever this 5 blank “replies” from Ari is a bit ridiculous.

[Erin]

Hey Mathew, I’m feeling you in your frustration and just want you to know I’m seeing/hearing you. When someone you love is suffering and you’re looking for support and are met with mostly crickets it can be very disheartening.

I do recall reading Ari’s posts at some point where he was talking about having a similar experience with a family member as well and I think he offered for you to reach out to him. So perhaps this was a technical glitch that they were deleted? You could try messaging him directly.

If it were my family member I would explore what occurred just before he made such an extreme decision to end his engagement and become a monk. Was he feeling trapped? Was he paralyzed by fear? Did he have a fear of being punished or attacked and went into a freeze response for safety? Was he feeling powerless or worthless because he was unable to respond in a moment of crisis?

For his physical health are you all able to get him to drink high quality structured water along with taking cell salts? You could even dissolve them in his water if compliance is an issue. Are there windows in his room? Can he feel sun on his face and breathe in fresh air from the safety of his room in this way? Are there any scents/smells that are meaningful to him from a happier time in his life? The power of smell to trigger memories and shift our thoughts can be powerful. Or what about music he loved prior to all of this happening?

[Matthew]

Great suggestions, thank you Erin. I need to get back to using cell salts for my own family as well. Hopefully you did not feel my comment was in any way directed at you as it certainly was not intended to be.

[Matthew]

And I like the suggestions about scents and music. I had been thinking about getting some of his old friends to make a short video for him sharing a few memories of good times. Being not that sensory myself, I hadn’t thought about the more straightforward sensory triggers!

[Erin]

No worries, I did not take it that way! Just wanted you to know I was hearing you 😊 Have you connected with Ari? It seems his post was deleted again, at least it appears that way on my end. I think it’s a technical glitch.

[Ari]

Just me deleting my posts. Happy to be a support, if desired.

[Author]

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