Jenny’s voice trembled: “Reverend John, I’m at my wits end. That man with the hairy chest watches me all the time. When I go to the bathroom, he stands there, laughing at me. I can see him in the mirror. I have to sleep with all my clothes on, so he won’t see me naked. I’ve prayed, every night, but he won’t go away. Please Help me.” Her swollen, arthritic fingers clasped tight in prayer. Tears streamed, staining the deep wrinkles lining her face.
Reverend John Anderson’s rich baritone reached each corner of Jenny’s tiny kitchen: “Jenny, your imagination is running away with you. This can happen when you live alone. Our dear Lord is watching over you. He will protect you. No harm can come to you. Keep this prayer book. Read it night and day.” John Anderson tried hard to be patient. For the past week, Jenny, her voice frantic, had called him every morning at 6:00 a.m.
86-year-old Jenny Thomas, diagnosed with a dementia three years ago, had been a faithful member of the Church since her mother dragged her to confession at age 22, unmarried, and pregnant. John Anderson, not yet ordained, a student at the Theological Seminary, was learning how to help those in need. “We must always be gentle as we guide those who sin, to see the error of their ways,” his superior had advised him. Many years later, caring and compassionate, John prayed with Jenny, visiting her once a week.
John met with Jenny’s daughter, Miriam, whose voice held both exasperation and fear:
“Reverend, my mother is acting weirder every day. Yesterday, shivering, hysterical, she hollered for me to call the police because she saw the same man trying to climb into her bedroom window. I’ve reassured her every day that there is no man. She doesn’t listen. My mother was never like this. She always acted like a perfect lady, very proper and self-controlled. I can’t stand it anymore. The doctor wants us to put her in a long-term care facility. He prescribed tranquilizers, but when she takes them, she sleeps all day.
I don’t want her to turn into a zombie. What shall I do?” Reverend Johnson listened with empathy. Together, they prayed.
Reverend John Anderson decided he needed to learn more about how to better help people like Jenny and Miriam. He chose the Certified Validation Worker course which taught him a basic attitude and techniques specifically useful when communicating with older adults living with Alzheimer’s and similar dementias. He became more empathetic, non-judgmental, was more able to put his own thoughts and feelings away in order to enter the personal reality of the other person. He incorporated verbal and non-verbal techniques that worked flexibly and consistently. He was now able to help Miriam and Jenny.
First, he taught Miriam to CENTER: to wash out her feelings by taking deep breaths into her nose and out of her mouth. “Miriam,” John’s voice was gentle and caring: “If you are full of your own fear that your mother is acting weird, you can’t possibly step into your mother’s world. This is very hard to do when you are working with your own mother, especially with sexual issues. I teach Centering every Sunday after church. With practice, you can learn to Center quickly, to shelve your own emotions. Second, to know which Validation technique to use, you need to feel what your mother feels….to step into her shoes. That is empathy. With empathy comes trust. Techniques can be sterile without empathy. To gain empathy, carefully observe her physical characteristics. Take an emotional temperature of your Mom. Validation calls this, ‘Calibration.’ Begin with her eyes. When she talks, her eyes are often closed. She may be seeing this man with her mind’s eye. Her breathing is rapid, which could be an indication of fear. Lower lip, quivering. Speech is clear, but shaky. Her voice tone is low, in a whisper. Perhaps she is afraid of something from her past. Perhaps she is ashamed and doesn’t want you to know what happened long ago. She moves erratically, darting back and forth, fingers searching, as if she were looking for someone. Motion attracts emotion. The way we move, often reflects how we feel. Third, review her developmental history. How has she faced her life struggles from birth to old age?” There is always a reason behind behavior.
Gently, he continues: “Miriam, you know about your mother’s first pregnancy. I knew her then also. Maybe she never expressed her shame at her pregnancy, her guilt as she surrendered her baby, her conflicting sexual feelings towards the father of her child. I suspect that she never resolved all those feelings.”
The most important principle underlying Validation theory: Painful feelings that are expressed, acknowledged and Validated by a trusted listener, will lessen. Painful feelings that are suppressed, will gain in strength, and after many years, begin to hurt. It could be that Jenny never learned to express her deep emotions directly, so now she has entered a final struggle: Resolution. She wants to resolve the guilt, shame, anger and fear haunting her for over seventy years. For Jenny, present reality is blurred because of increasing deterioration to rational thinking, adult controls, self-awareness, eyesight and hearing.
John, trying to help Miriam find empathy with her mother asks, “Can you think of a time when you weren’t sure of where you were?”
Miriam, deep in reflection, nods, “I had double pneumonia and had to go to the hospital. I was afraid of the doctor who examined me.” John asked, gently: “Miriam, can you feel that fear now? In a weak voice, Miriam whispers, “yes.” John continues: “Where do you feel it.?”
Miriam points to her heart. “When your Mom sees that man, don’t argue with her. He is a symbol of someone from the past who has hurt her, of whom she is afraid. Very old people often create a symbol in present time to restore painful feelings from the past. They struggle to heal by expressing deep emotions they have denied for a lifetime. She sees the man clearly, in her reality, with her mind’s eye, to finally express shame and guilt. Feel her fear, her shame, and her guilt and listen with empathy.”
When Miriam felt comfortable with using this basic attitude, John continued to teach her a few simple validating techniques. “These will help your mom express her emotions, relieve her pain and help her live and die in peace. It’s too late to confront her with a painful reality she could never face.
- Re-phrase: Re-phrasing comes out of exquisite listening.
Listen with all your energy. Pick up her pitch, her tempo. Does she talk fast or slow? Which words does she emphasize? Repeat the gist of what she says in your own words, in a question, picking up her emotion. Re-phrasing establishes trust.
Example: John asks Jenny: “Do you mean he watches you all the time?” Grateful for the understanding, Jenny is able to express more of her feelings.
- Use her Preferred Sense. We all have a preferred sense: visual, auditory, or kinesthetic. Jenny uses many visual words. John will use her preferred sense to help her express herself easily. She sees the man clearly. What he looks like? The color of his hair? What is he wearing? etc.
- Reminisce. Ask her if she has seen him before. Does this man remind her of someone she knew?
- Use the extreme. Ask her: “What is the worst thing about this man?”
Use these Validation techniques once each week for about fifteen minutes. Keep in mind that on a deep level of consciousness, Jenny knows there is no man. Jenny has created him to express the anger, fear, and shame she felt many years ago when she became pregnant. Each time, Jenny expresses more of her fears to Reverend Anderson, she feels relief. Painful emotions lessen when they are expressed to an empathetic listener; we have all experienced that. Jenny feels relief each time she expresses her emotions to John. She may, after a few months, confide: “Reverend Anderson, I must tell you, that the man is gone. I hope he won’t come back.”