Self-care is increasingly identified as a foundation for physical and mental health and wellbeing. It can be explained as self-directed activities a person engages in with the goal of moving towards a more optimal level of health. Self-care activities involve general daily living tasks (such as healthy eating, getting enough sleep and regular exercise) and can incorporate additional self-initiated activities that may be viewed as relaxing (yoga, meditation), pampering (massage, facial, movie) or a social outlet (date night, catching up with friends).
Many teachers report having insomnia at some time throughout their career. Insomnia is the experience of difficulty getting to or staying asleep, and the subsequent sleep deprivation that results can further add to the stress a teacher already experiences.
When someone finds it difficult to sleep, they often also experience a degree of anxiety and/or stress. This is sometimes referred to as the ‘fight and flight’ response. The body changes that occur during the flight and fight response include an increase in heart rate, tense muscles, increased speed of thoughts and feeling jumpy/jittery. If these bodily changes become a pattern or habitual response to stress, it can prove more and more difficult for a person to recognise the signs of its onset. An accurate predictor of a switched on ‘fight and flight’ is when the brain feels like it is ‘active and on alert’.
Using a Safety Tool or Personal Safety Plan in Emergency Departments or Mental Health Inpatient Wards.
Safety Tools are being found to be very useful in emergency departments and on mental health inpatient wards, as they incorporate aspects of trauma informed care and also provide some options for using sensory modulation in the hospital environment.
Safety Tools are sometimes also known as personal safety plans. Many hospitals have their own versions, developed in collaboration with consumer consultants.
Having been a new parent, I know how hard it is to settle a baby at night who does not settle after feeding and is noticeably distressed.
As a new dad, I found this scenario to be extremely difficult to handle, especially when you are battling to stay awake due to sleep deprivation.
I would often give up attempting to settle our baby and put the experience into the “too hard” category, often relying on my partner to do the settling.
It took me some time to learn some valuable lessons about the benefits of persisting with feeling uncomfortable and embracing the experience of attempting to settle our baby during crying and screaming episodes.
I want to share what worked for me.
The NSW Government is investing $20 million to help hospital managers improve the therapeutic environment inside acute mental health units – isn’t that great news!
Julie and I have had a lot of conversations over the years about designing our ideal mental health inpatient unit and in this blog we discuss some of the main points.
Sensory Modulation Brisbane is excited to be registered as a NDIS provider. As the NDIS has just rolled out in Brisbane, we are on a steep learning curve!
Sensory Modulation therapists have experience in mental health, sensory modulation, sensory processing and dialectical behavior therapy.
Clinicians are able to work with individuals to identify psychological and sensory factors that can be enhanced to make it easier for people to do what they want to in the home, in the community and with other people.
The sensory aspects of eating and drinking (the smell of hot chips, the taste of chocolate milk, the chewing and swallowing of biscuits) may provide people with the neurological input needed to help shift how they feel. While the goal of changing negative feelings is a good one, some strategies used to achieve this (such as over-eating) may result in negative outcomes. Different sensory strategies could therefore be adopted to provide the desired sensory input, without the negative effects of emotional eating on health and well-being.
The Sensory Modulation Resource Manual was published earlier in 2018 as an ebook and paperback. We have been getting some feedback from different people and professional groups about what they find useful about the book. We have had feedback from Nurses, Teachers, Occupational Therapists, Parents, Architects, Dentists, Non-Government workers and many others.
Clinical Nurses in Mental Health are finding that the book provides useful resources for using sensory modulation to reduce seclusion and restraint on the inpatient unit. This includes information on designing different spaces or zones within the inpatient unit for different sensory input (sensory spaces), suggestions for equipment for the sensory spaces and a guide to getting starting in using sensory modulation with a client. In June 2018, the NSW government allocated $20 million to improve therapeutic environments within mental health units. The Sensory Modulation Resource Manual is a useful resource for this project.
Teachers are reporting that the Sensory Modulation Resource Manual is useful in understanding the individual sensory preferences of the children in the classrooms and tailoring strategies to the individuals. The section on calming strategies has been popular, in particular using the playground for calming. High school teachers and Guidance Officers have liked the lists of strategies to improve focus, and decrease anxiety.
Studies conducted over the last two decades continue to demonstrate the strong connection between nature and well-being, for example:
· Contact with ‘blue space’ (living near the ocean) is associated with reduced levels of psychological distress (Nutsford et al, 2016).
· Views of nature (ie - mountains, oceans, waterfalls, star filled skies) create feelings of wonderment and awe, altering our experience of time and increasing feelings of unity, connection, patience, and a desire to help others (Rudd, Aaker & Vohs, 2012).
There is growing evidence that balance, movement and proprioception (the sense or awareness of our body in space) can play an important role with managing anxiety.
Mental Health inpatient units are increasingly using Sensory Modulation strategies to provide options for people to self soothe and self regulate. One strategy that many people find useful is the use of cold temperature items. This can include using ice sprays, disposable ice packs, zip lock bags with cold water, cold slushies, cold water in sinks, cold stress balls, and chill towels.
At Sensory Modulation Brisbane, we have clinicians who often identify topics for research, but who are unable to research them due to time or logistical restraints. We are very aware of the need for further research on Sensory Modulation, so we are going to list ideas through blogs when we have them.
Sensory Modulation can be used to change how you feel through using your senses. Sometimes Sensory Modulation is described as useful for calming and alerting but it can be used a lot more widely than this. We have made an infographic to show simply what it can be used for:
Using the scent of a loved one or scent of a loved place to provide feelings of calm.
When there is a new puppy in the house, a common strategy is to put a cloth of the owners near the puppy, so that the puppy can smell it and feel safe. It is also common with human babies to use the scent of mum or breast milk to keep the baby feeling safe. This blog is about exploring using this strategy with older children and adults also.
The first step in using scent, is to identify the scent that reminds them of the loved one. For parents of children, a useful strategy can be for you to sleep with several handkerchiefs, or an old t-shirt. Then give your child that item to sleep with. This may be useful to try with younger children with separation anxiety on going to school.
Adults with anxiety sometimes use the handkerchief technique as well to use the scent of their partner to calm them when they are out. Other clients use scents that remind them of the individual instead. This could include:
- perfume or cologne
- hair shampoo or conditioner
- hand cream
- particular soap
- laundry detergent
- particular foods (eg cumin, lemons, garlic )
- garden plants eg tea tree, roses.
Once the scent is identified, then put the scent into a small bottle, zip lock bag or onto a handkerchief. Smell the item when feeling anxious or needing to feel safe.
For some individuals, there is a preference to identify the scents of a safe place or happy location. I have known clients who have used:
- sand to remind them of the ocean
- books to remind them of the library
- gum nuts to remind them of the bush.
The scents of a loved one or loved place have a very quick association with memory and with the social safety system. Using a scent can turn off the 'flight and fight' system or danger part of the brain. Feeling safe can really help us to relax and then be able to go about our daily lives.
" By increasing smell input such as by smelling the perfume of a loved one, we can activate an immediate pathway to the limbic system. Smell is the only sense that does not travel through the brain stem first, and it has a strong and fast connection to positive or negative memories.
" Sensory Modulation Resource Manual" (2018) O'Sulllivan, J. & Fitzgibbon, C
"Aroma's work their therapeutic magic by evoking a learned association in the smeller"
The scent of desire: discovering our enigmatic sense of smell)
(2007), Herz, R. S.
We have made a short video on sensory modulation. This has some quick strategies that can work for anger.
Sensory room or sensational space?
In Australia, new legislation has come in to restrict codeine from being able to be sold as an over the counter medication. This is due to a large number of people who have overused or become addicted to codeine. After the medically supervised withdrawal from codeine, we have had clients who have asked for Sensory Modulation strategies to assist them. Many of the clients that we see are using Codeine to feel calm or numb from intense emotional feelings. Other people use codeine to manage pain, but today we will focus on the numb and calm strategies.
Change how you feel: feeling numb
People who experience intense and overwhelming emotions sometimes want to feel numb from their emotional pain. The numb feeling has been described as thinking less, or not feeling the emotion (including the physiology of the emotion). Some people identify that they use substances such as codeine or alcohol to feel numb. These strategies can be used as an alternative to using substances or to create a feeling of numbness:
1. Changing temperatures:
- alternating cold showers with warm showers
- immerse self in or rub icy water over body and then have a warm bath
- go under a waterfall, ice bucket challenge
2. Humming Breath:
- put ear plugs in, or hold fingers over ears to close them. Then hum loudly on the breath out. This will provide a vibration feeling around the sinus area
- spin around in circles
- go on a roundabout or other playground equipment
4. Lengthy intense exercise
- dance wildly
- run for a long time
5. Other intense sensations
- Suck a lemon, smell aniseed, suck a warhead, apply a heavy facial etc.
Check: Are the strategies SAIM? Safe, Appropriate, Individualised, Meaningful?
What is Sensory Modulation?
Sensory modulation is ‘changing how you feel through using your senses’. The senses include touch, movement taste, smell, sight and sound. Depending on the type of sensory input and our unique preferences, sensory modulation can increases feelings of calm, energy, improve focus and enhance feelings of safety and connection. More information available in “Sensory Modulation” Resource Manual (2018) Julie O’Sullivan and Carolyn Fitzgibbon ebook (Amazon)
More sensory modulation strategies are available in the Sensory Modulation Resource Manual available on kindle
Sensory Modulation can be used to change how a person feels through using their senses. This includes any items, activities, environments or that use sensory input. To give you some ideas, these are some examples:
- using a rocking chair with an agitated person with dementia to assist them to calm.
- sitting a pet on your lap when feeling sad
- splashing face with cold water when angry
- walking in the bush to feel less stressed
As there are so many possible options, it is useful to ensure that Sensory Modulation is:
- Safe: emotionally and physically
- Appropriate: age, gender, culture, identity, environment, and affordability
- Individualised: tailored to unique preferences
- Meaningful: does the person know why it is being offered? Does it make sense to them?
A way to remember this guideline is SAIM.
Sensory modulation needs to be beneficial for the person using it and this includes being emotionally and physically safe.
Emotional safety means that clients need to feel that using sensory modulation is not traumatising, triggering, demeaning or punitive. A sensation may be ‘safe’ for one person but ‘noxious’ for another. Many people are aware of the sensations they find aversive.
Physical safety considerations including not causing injury or allergy to the person or other people.
Considerations for whether sensory modulation is appropriate, include the following
An appropriate sensory item for an adolescent is different to an appropriate sensory item for an adult or an elderly person. Some sensory modulation items are childish looking and can result in a person feeling embarrassed or insulted.
Some clients may feel that an item should only be used by a particular gender.
Culture and identity
Cultural considerations include religious, political, race and other belief systems.
Consider privacy, noise levels, sunlight, insects and access. What is appropriate in one environment may not necessarily be appropriate in another: for example, a lounge room versus a workplace.
In a hospital or medical environment, sensory modulation equipment may need to be durable and therefore more expensive. However, cheaper and more affordable substitutions should be available. It is important that a person can afford a sensory item if they find that it works for them, particularly so they can use such items at home. A range of low-cost options should be considered, including items found at dollar shops and op shops, and items that can be made. Sensory modulation can also occur without purchasing any equipment, through using everyday household items, natural settings and free parks and gym equipment.Innovative and inexpensive ways of making your own sensory modulation equipment are also available, with many great ideas available on the internet, Pinterest and you tube. (For example, https://au.pinterest.com/SensoryMod/)
Each person will have different sensory modulation strategies that work for them. This is due to differences in the following:
- sensory processing
- past experiences
- individual meaning attached to a particular item
- current mood.
Orientation to the purpose of sensory items is crucial for them to be meaningful. Without context, asking someone to put a weighted pillow on their lap or dunk their head in icy water could be perceived as quite strange!
Sensory modulation is more effective when incorporated into daily occupations such as work, study, leisure, housekeeping, and self-care. A person is more likely to use sensory modulation if it becomes a routine in daily life, or if they use it while engaging in another activity.
We hope that using the SAIM guideline assists you with using Sensory Modulation. There are more details on using Sensory Modulation and SAIM in the book "Sensory Modulation Resource Manual"(2018).
There are many different definitions of Sensory Modulation. Sensory Modulation is often referred to as a neurological process as well as an intervention. In this blog we will discuss Sensory Modulation as an intervention. Sensory Modulation is recommended in Australia under the Australian Recovery Framework and this important document refers to Sensory Modulation as an intervention that is useful in crisis situations. At Sensory Modulation Brisbane, we define Sensory Modulation as:
"Sensory Modulation is changing how you feel through using your senses. "
Carolyn Fitzgibbon and Julie O'Sullivan, 2013
To understand how using sensory modulation changes how we feel, it is helpful to look at what is meant by ‘how you feel’. This phrase can refer to the experience of the physiology of the body(for example, to feel sick, hungry, in pain, cold or tense) or it can refer to the alertness and focus of the brain (for example, awake, unfocused or tired). ‘How you feel’ can also describe experiencing emotions such as feeling sad, happy, angry or scared. When sensory modulation is described as an intervention that can change the way you feel, it is describing the possible shifting of any of these described states, through using sensory input.
As a therapeutic intervention, sensory modulation is most commonly used to change strong emotions, manage pain or to improve focus. To use your senses refers to sensations of touch, deep pressure, temperature, vibration, movement, taste, sight, smell, and hearing. There are different ways of obtaining this sensory input, involving activities,occupations, items or the environment.
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