Barrett L. Dorko, P.T.
I don't think it's possible to live in our culture for more than a few days without encountering at least one reference to the classic movie The Wizard of Oz. Just try it and you'll see what I mean. I can't personally think of any story whose themes are as compelling and universal, and I know I've published at least four essays about its connection to therapy in the past. This is yet another.
In the latest issue of The New Yorker there is a wonderful article by John Lahr (The Lion and Me, November 16, 1998), the son of Bert Lahr, whose portrayal of the Cowardly Lion was both hilarious and touching. He says of his father, "If Dad had had a tail, he would have twisted it just as the Lion did; instead he made do with his buttons..."
Bert Lahr's "global anxiety," according to his son, created a man paralyzed and pathologically introverted when off stage. He was the Cowardly Lion, but without the courage necessary to admit it and move toward help.
In the movie, the Lion's false bravado and his threat to Toto forces Dorothy to smack him on the nose. His reaction is way out of proportion to a simple, non-injurious slap, and it quickly becomes obvious that the pain is not really the problem; it's his fear.
I wonder how often my patients blend their pain and fear together to such an extent that anything frightening is experienced as agonizingly painful. I've certainly seen a few who feign bravery and effectively hide their private terror. On stage, Bert Lahr took this to a high art.
I should mention that Dorothy accompanies her slapping with the words, "Shame on you!" and, predictably, the Lion is reduced to tears. There are forms of manual care that seem to carry similar elements of painful pressure along with an overt indication that the patient is somehow fundamentally "wrong" in their way of being. To me, this would be something less than therapeutic, and, if I were scared to begin with, distinctly traumatic. Still, I hear of it all the time.
As soon as the Lion confesses his fears, Dorothy gently puts a hand on him. Despite their very recent and fierce encounter, she just touches him as if she were already his friend and confidant in his ability to do what he needs to get better. I call this "Simple Contact."
The story being what it is, Dorothy says, "I'm sure the Wizard could give you some courage," and they dance off toward the Emerald City.
You may recall that in the end the Wizard provides the Lion with only a medal, something that acknowledges his inherent courage, and that it is enough.
Maybe we can be as gentle as Dorothy once we see the fear in our patients. Maybe we can be as wise as the Wizard, encouraging them with words and acceptance.
When we see someone so sensitized by fear that the slightest poking hurts, maybe we should simply touch them instead.