Sensory Modulation

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.

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:

• deodorant

• 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.

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Sensory Modulation video for anger strategies

We have made a short video on sensory modulation. This has some quick strategies that can work for anger.

Coping after codeine

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

3. Spinning

• 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

Using Sensory Modulation so that it is Safe, Appropriate, Individualised, Meaningful (SAIM).

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.

Safe

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.

Appropriate

Considerations for whether sensory modulation is appropriate, include the following

Age

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.

Gender

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.

Environment

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.

Affordable

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/)

Individualised

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.

Meaningful

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).

Changing how you feel through using your senses

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.

Reducing Seclusion and Restraint though using Sensory Modulation

In Australia, there is a National Policy to reduce Seclusion and Restraint in Mental Health Services.

Sensory Modulation has been recommended as one of the strategies to assist with reducing and eliminating seclusion and restraint. We are often asked how this would work.

Ideally, sensory modulation items would be available and easily accessible in mental health units and nursing homes. This would mean that if someone started to becomes distressed, agitated or angry, they would be able to easily use one of the available sensory modulation items. This could assist them to calm down. This can include items such as ice gel packs, weighted cushions, warm blankets or wraps, weights or exercise machines. Having these items in some environments requires a balancing of the benefits of having something that can calm someone down vs the risks of having these items on the units. In some places, sensory modulation items are only available in a room or at the nursing station. This then means that an agitated or angry person requires support to access the items or the room when they need it, in a timely manner. At Sensory Modulation Brisbane, we have a preference for sensory modulation items and calming activities to be generally available in units so that the person can easily access it when they need it. Some items (eg weighted items) require additional training or information from an Occupational Therapist.

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Using cold to calm

It is starting to get warm in Brisbane so using heat packs and hot water bottles isn't really what we want anymore. This month we have been trying some new icy sensory items. This has included slushies, eye shades that can be frozen and cold squeeze balls. These items have been really popular and have been reported to help with grounding and also with anxiety. Another option is to wet a towel and wrap it around the shoulders. This helps to cool down and the weight of it also has a calming effect. There are more products on the market that can be bought but it is also possible to make your own cold sensory item. Try putting sensory items in the fridge or freezer. We have tried stress balls and smooth stones and have also frozen grapes. Cold is an intense sensation but one that can be used to change the mood. Just make sure that you don't give yourself a freezer burn!

Sensory Processing or a Medical Issue?

A person may come to an Occupational Therapist seeking information on their Sensory Preferences. They may want to know if they are sensitive to visual input or seeking of movement or strategies to manage their sensations. An Occupational Therapist can provide assistance with this information by using assessment measures such as Winnie Dunn's Adolescent/Adult Sensory Profile. 

Sometimes when we are discussing Sensory Preferences, we work out that the sensitivity to sensory stimuli has only been for a short period of time. This can indicate an underlying medical condition including physical or mental health issue. An Occupational Therapist will often refer a person back to their Doctor or another health practitioner to assist with this.

Some of the medical conditions that can be confused with a sensory processing issue include tinnitus, hyperacusis, glaucoma and post traumatic stress disorder.

It is worthwhile to speak to an Occupational Therapist to understand your senses, your preferences and to assist in the process of identifying underlying medical conditions.