Saw a patient today with tardive dyskinesia, disabling, permanent and uncommon condition caused by long-term use of antipsychotic; he suffers continuous and involuntary movements in his mouth and face. He also suffers insomnia. His med had been decreased due to the side effects. I told him I could help him. (I tend to say yes first and make it work) I said, “Two things to do. First, 400 grams of non-starchy vegetables to provide substrate for the brain to heal. Second, meditation (BAM) that will increase your ability to pay attention and “quiet” the injured part of the brain that is causing the facial movements and allow healing to begin”. That all seemed quite logical, at least to me. He also seems to liked the ideas, perhaps out of desperation. His wife added at this point that he is already more energetic from eating more greens since the last time we talked. She said, “He even shoveled the snow”. I encouraged them both to reach the daily “therapeutic” vegetable target of 400gm. Then I wondered how I would teach BAM to him; mindful of his incessant and involuntary facial movements. I didn’t want to ask him to pay attention to his upper lip (customarily the first target of attention in BAM). So I said, “hold your palms together and pay attention to how the two opposing thumbs; then wait and when you notice the natural breath appears, switch your attention to the opposing index fingers; then once again wait and when the natural breath appears again, switch your attention to the opposing middle finger...” we continued the exercise for sometime and I finally opened my eyes. I noticed his wife was staring at us in astonishment. She eagerly asked him if he was able to do it. He said, “yes”. She then said to my great surprise “his face stopped moving during the entire meditation”.
So we parted and agreed to meet in 2 weeks. They will eat the greens three times a day; and he will practice BAM three times a day.