I sit here in the living room of a place that I moved into a couple of days ago surrounded by half unpacked boxes. Behind me is the TV … I wanted to watch Bones last night, but do you think I could find the cords for the antenna or power? Nope. I did find the ordinary drinking glasses that I was determined to unearth the evening before. Eventually (after Bones was over) I did find the cords … in a shoe box that the removalists conveniently placed on the TV unit (duh! I had just put a stack of papers on top of it). This is what happens when you are too busy to do all of the packing yourself and get the movers to help with the packing! I know exactly what is in the boxes I packed … they’re also labeled with more than the room that they were packed in. I am in the process of washing every bit of linen that I own because everything has been in storage for a couple of months in cardboard boxes and a lot of it has been wrapped around sundry items for padding … it all smells musty. The clothes from storage will all need ironing before I wear them (although the were bagged in somewhat more smell-proof containment for the most part so don’t all need the wash fest …
It strikes me that life is a bit like this. It’s all a bit of a journey. We can mark time for ages and not feel like we’re going anywhere and yet be changing all the time; we can be going backward, or round in circles … or other times our world shifts and we have to figure out what to do with everything that we have and all that we are. The things that we think are important get re-sorted and stored differently and things find new places. Some things it is hard to fit. Other places leave vast holes. Some things about our new places lack things we really liked about our old worlds, yet there are things that perhaps are vast improvements and what we would wish for might be a mixture of both … but a journey doesn’t allow that. We must leave one place in order to go to the next and then to keep moving onwards.
This is what the process of living with Depression has been like for me. When I discovered that this was what was going on in me and that it was not going to resolve itself and just go away my whole world shifted. Dreams died. Hopes were broken. My heart broke. I needed to learn how to travel a different journey. It has been a long road, and the path has not followed the course that I thought it would, but I find that perhaps broken hopes heal and perhaps dreams don’t need to die after all. Perhaps they look a little different to the glorious picture that they once were. Perhaps they are now more humble. The journey is not over, it is a life long one … there is always room to grow and that includes the times where health is not great. My heart has been healing and knows joy.
In the mean time, I unpack my boxes and place my bits and pieces in their new homes for this next leg of the journey.
It’s one of the first things children learn to say.
“It’s not fair!”
It could be.
It might be.
It might not be.
Lots of the time it’s not.
I was picturing life as fair a couple of weeks ago.
There was an endless row of storks lined up for miles on end, each with its very special bundle to deliver.
Each bundle was allocated – not necessarily the same things but things of the same weight and number.
So each stork took on ‘x’ amount of tragedy and ‘y’ amount of suffering and ‘b’ amount of joy and ‘c’ amount of strengths and ‘m’ proportion of weaknesses. And then there was a minimum space indicator allocated for tragedies and suffering – so they couldn’t come on top of each other – because “fair” – as we all know – allows time for healing. And each of these little bundles then was given a special value key that they would hold each other’s strengths and weaknesses, joys and sufferings, tragedies and so forth as as valuable or important as their own.
But life’s not like that.
Storks are impatient creatures.
They fly out when they’re good and ready and often when the load’s not ready to go.
And tragedies and suffering, joy and strength and weakness don’t get dished out in measured helpings at nice comfortable intervals either.
No. Life’s not fair.
It’s not really designed to be.
In lots of ways we’d be a lot more content if we all stopped looking for fair.
Sure, I think that we should act in a way that is decent and even-handed to others when we get the choice … but there will always be someone who thinks that a choice wasn’t fair.
Why do I have treatment resistant Depression? I don’t know. Essentially because I had brain surgery for an aneurysm that they found.
Would it be more fair if it hadn’t been found and I’d have died in tact in my mid-20s?
What sort of question is that? Both were possibilities. Neither seem ‘fair’ to people who love me or my family.
Do we have to remain in some kind of pristine condition for things to be ‘fair’ then?
How old do you have to be before it is ‘fair’ for your body to start deteriorating?
No, if we go by what we usually think of as ‘fair’ then almost nothing is fair.
I don’t think life is designed to be fair.
I think it’s about growing and letting ourselves learn from the things we encounter.
I’ve met quite a lot of people who have been through a lot who are wise.
I think that they’ve learned what they could from the hard times and the scars that they’ve left.
So I’ve set my sights anew.
I want to be wise.
(but maybe by learning efficiently, not by having too many lessons????)
Yes, I am still here. Still living, breathing and blogging. Just fell victim to a couple of very shocking weeks (interspersed with some lovely moments, but very few and far between).
This week I’ve barely been able to tolerate daylight, let alone the computer screen – migraine like I have not had in a long time since my medication includes migraine voodoo concoctions … but … amidst my Barry Crocker of a week the week before and the ensuing weekend I became a bit disoriented and missed a couple of doses of my meds, hence the hole in the firewall (just to mix some more metaphors). Yesterday I went to the GP to get a medical certificate for work and stopped at the shopping centre on the way home. Talk about sensory overload! My world had not yet totally stopped spinning so I had this strange spacey kind of sensation as I was walking, the noises were louder and more jarring, lights and colours still bright, smells still sharp. I couldn’t get out of there fast enough!
Work has been crazy and exhausting trying to manage the politics and dynamics within the office. Don’t get me wrong – I like my job. If only work could just be about going and doing your job and coming home again, what a relief it would be! But there are systems and other people that one has to navigate to do one’s job. Equipment that one and space one has to somehow get adequate access to do it. Preferably in a way that lets you stay well without creating more stress than is necessary – which is where the battle lies at present for me. At present it seems that I am destined to bang my head against a brick wall and progress nowhere and to endure life in the office that gets claimed by miscellaneous team members to serve as their staff room – while my office buddy and I are trying to work in it!!!
But alas! These are not healthy things to dwell upon. The goal is to work out how to attack and push through. I had thought that we had had a strategy for the work one, but it is back to the drawing board on that one next week as it looks like this is rapidly fading into embers.
At present I am struggling not to dwell on the difficulties of the last few weeks. I grew frustrated that my usual seasonal dip in mood was dragging on longer than usual, but didn’t really look beyond it for other triggers until much too late. Sitting down with a friend a couple of weeks ago to go over what had been happening clarified things a lot more for me. One of the reasons that I am so focussed on work issues over the past couple of weeks has come about because through sitting down and working through my usual triggers and warning signs with my friend revealed that my workplace is simply loaded with triggers. There is little wonder that I have been struggling to emerge from my usual brief decline and regathering of mood.
It’s so easy to forget to go back to the basics when one gets busy. I can sort of see why Mary Ellen Copeland, the woman who designed the WRAP suggested that going over triggers and warning signs should be something that someone should do daily to prevent relapse. I’m not sure that I would ever go to daily, but I do know that I need to be going over my WRAP a lot more frequently than I do. The whole point of knowing one’s triggers and warning signs is so that you can be alert to them. It’s one thing to know them – but so easy to miss them unless you’re really watching.
So – What do you do with the shockers? Do you beat yourself up over them? There’s no point in that. To me, it seems you need to do is stand back and detach a little. Stand in the moment. Not the future. Not the past. Just the moment. Examine – and for me, it helps if I can find someone to help me stay in perspective … at least to get me going – and learn. This helps me to see cause and effect relationships; it helps me to learn and relearn trip hazards; it helps me see things specifically rather than looming ghouls and it leaves room to remember that there were a couple of good moments in the last fortnight too.
From there I can start with a plan. If the plan needs adjusting, then so-be-it, but perhaps – just, perhaps … next week can be a bit better …
If you have a mental illness do you tell your boss?
Are you obliged to tell your boss? Why or why not?
With discrimination rife in society and difficulty getting friends and family to understand what you are going through, what are your greatest fears in the workplace? Or the study environment? Or wherever it is you spend most of your productive time?
Does your illness affect your ability to do your job at times? In what ways?
Does your boss know? Do any of your colleagues? What led to them finding out?
Whether you are studying or working always consider ahead of time whether you are prepared to disclose your illness. If your current position is non-disclosure, consider carefully any occasions which might arise which might make it more necessary and under what circumstances you may disclose if at all.
Disclosure is always best done in a planned manner. You should have some idea what you are going to say, how you want to say it and how you are going to explain its relevance to your work. If you need some adjustments to your work conditions or some time off, it is best for you to come to your boss with some options that you have considered and reasons for your request. You need your boss to understand that you wish to be healthy and productive as possible and are trusting them so that they are able to best support you to reach a goal that is in both of your best interests. A large proportion of ‘Western’ countries, including Australia, provide legislation to support your right to this.
When you plan what to disclose think in terms of how you are affected by your mental illness more than your diagnosis. You may, in fact decide to disclose only the effects of your illness and not your diagnosis, stating that you have “a condition that affects …”. You may identify symptoms or you may simply describe what it does to you and how that affects your work eg my condition means that I have less energy than I used to have. This means that I have to be careful how I plan my time and that I have to take holidays at regular intervals throughout the year to maintain stable health. I need to be careful to use my meal breaks and leave on time so that I don’t become over-tired. Or my condition means that I need to take medication. When I change medications, sometimes I am more sleepy than usual and over-sleep or become very drowsy in the afternoons. Sometimes my speech even gets slurred and I sound a little intoxicated. So if I’m changing medications I need to take a week off, otherwise I find that I’m coming to work late all week and I sound as though I’m tipsy for half the afternoon and I don’t get much done and am at risk of making faulty decisions or overlooking things because my head is all foggy – especially in the first few days. After that I will be fine at work again, but might over-sleep a couple of times in the 2-3 weeks afterwards while my body gets used to the new meds. It doesn’t happen very often. I’ve only needed to do it 2 or 3 times, but each time I’ve been glad that I did.
You do not need to disclose specify personal or medical information if you tell them about anything at all.
You should also think about when to disclose. That is – when you are applying for a job, before a job interview, during the interview, after you have been offered the job and before starting, during the time you are employed after you have worked there for a while, if you become unwell and need to or never. There are pros and cons of disclosing at each point of the way. Sometimes your circumstances will have presented you with little choice to prevent awkwardness – you may have become unwell at work and have it become obvious that something was wrong or you may have symptoms that you are aware will soon become obvious if arrangements aren’t made to cater for your needs. Again, despite prejudice and stigma in some places you have legal rights to have your needs and confidentiality met and protected within your workplace in most western countries. Further, in Australia at least, if you become unwell because the employer failed to attend to your needs having been made aware of them, you are entitled to compensation under work cover. It is however, worth serious consideration whether or not you are going to disclose because unfortunately discrimination does still happen and there are people who do fail to respect privacy and you never know where they are until you find them.
Some helpful things to consider at each stage of the employment continuum.
Prior to interview
Why you might …
You are able to to discuss the organisations policies and support resources when exploring the prospective position
You are able to get an idea about your employer’s predisposition to your needs from the word go.
If you have restrictions on any key job criteria due to temporary limitations because of recent relapse/graded hours return to work plans.
Examples of Why you might not …
Risk of discrimination influencing whether or not you get an interview.
No work related needs arising from your mental illness.
You don’t believe that they need to know/believe it irrelevant to job.
At the job interview
Why you might …
You are able to address people after creating a positive impression of yourself and demonstrating your capability.
You can gauge their understanding of your meaning and clarify appropriate questions about your needs.
You are able to discuss with the employer positive traits that you bring to the team that you have learned through your journey of recovery.
You are able to discuss your needs and what your potential employer would be able to accommodate or explore during the interview process.
You can brief them as to whether your referees are aware of your condition and how it affects your work and offer consent to discuss previous workplace arrangements with other employers if they have gone well.
Why you might not …
Risk of discrimination in job selection.
You don’t feel that you have needs that require accommodating or can manage them without support from your employer.
You might worry about where information gathered by panel members will go and whether people are trustworthy to maintain your privacy.
Concern that even if you get this job, opportunities for advancement could be limited by poor understanding of your illness.
You might be well and consider it unnecessary at this point in time.
You might not want to distract the panel from thinking about your abilities by talking about areas of need.
When contacted with an offer of employment
Why you might …
You are able to discuss your needs without risk of missing out on the job due to discrimination.
You can arrange to enter the work place with a plan in place that accommodates your employment needs and commence as you mean to continue.
If required and with your consent, the employer can arrange appropriate mental health sensitivity workshops for managers or staff by organisations such as Beyond Blue or circulate general anti-stigma/population health information among routine organisation circulars, yet not make it obvious that it was for your benefit.
Allow development of appropriate support and mentoring systems.
Why you might not …
Fear of stigma, gossip and/or discrimination.
Currently well and don’t feel that you are affected at work.
Work does not need to know.
Protection of positive image and opportunity for advancement.
During the course of your employment
Why you might …
You decide that your employer is trustworthy.
You become unwell.
You encounter difficulties or are not performing to standard because of symptoms or medication side effects and need to offer reasonable explanation or require support, alternate work arrangements or time off for medication reviews etc.
You are being harassed or bullied.
Why you might not …
It might not be necessary.
Protection of positive image and opportunities for advancement.
It might result in harassment and discrimination.
You are able to manage your needs without workplace support.
Why you might …
Protection from gossip and discrimination.
Protection of positive image and opportunity
Lack of necessity
Why you might not …
Difficult to prove entitlement to compensation in case of illness, relapse or deterioration due to failure of workplace to meet needs for psychological health if they were not disclosed.
Relapse or need for hospitalisation might put your job at risk.
Might discover a positive attitude to mental health issues within workplace.
Legal obligations under occupational health and safety act where specific work related tasks are affected resulting in serious risk issues.
What did I do about disclosure to my employer with my job?
For me it was simple. I told mine. I disclosed at interview. I felt that this was necessary because I had taken my previous job without learning to manage my mental health well and my references would have reflected that in the answers to some of the standard questions that interviewers ask referees no matter how careful the referees were. I chose to take control of this situation at the time of my interview because having reached interview I could present myself as a competent individual in person, demonstrate that I was healthy and create a positive impression before and whilst disclosing. I also needed to disclose because I wanted to work less hours than the position entailed and needed to offer a good explanation. I told them that I had depression, how it affected me in terms of energy levels, concentration, seasonal patterns, medication changes and how I managed these things to be able to work. I spoke of arrangements that I had previously made with my former employer that had been helpful and asked if they would be amenable to such strategies. I also used the opportunity to tell them things that I had learned and accomplished through the experience of working, the determination and dedication that it entailed and the commitment to my job that resulted so that I could achieve personal satisfaction through working. In my case this had a positive effect and outcome, although it doesn’t always. I don’t disclose before I have the chance at interview to sit down and talk with the employer so that I can get a gauge on how they are reading what I am telling them and to avoid preconceived assumptions about what I will be like that are difficult to shift. There are always risks associated with disclosure, but my reasoning is that if they are going to discriminate when I am well, I would rather not have to deal with them if I were to relapse.
When I am in the workplace I lay low for a while and watch what goes on around me. As long as they are not untrustworthy, I tell someone if they are closely and directly affected by my health so that they are not left in the dark if I have to take leave at short notice. That’s usually only one or two people. Often they are among the first to notice that I am off my game, so it can work in my favour because when someone who I work closely with starts asking if I’m okay and comments that I’m not myself before I notice anything, it gives me a cue to step back and check my early warning signs and triggers. Over the course of years there have been a couple of people who have learned how to pick my good and bad days at least as well as I do myself and also to support and accommodate me through the bad ones and to lean on me in return when I’m good. I’m pretty limited in what I disclose to start with, but with proof of worthiness comes more trust.
My current situation in my new workplace is new to me. I have always had employers who were fiercely protective of my privacy before. I have little in the way of evidence about my current manager, only the report of one other worker about two specific occasions of breached privacy. I have, however worked in a place where it has been possible to work with my information kept private and so I am prepared to stand for my rights in both privacy and in workplace accommodation now. If I expect the respect of others, there may be times that I need to stand up and remind them what it entails. This is however new to me and the workplace is one with strange dynamics.
A while ago I spent some time blogging about how we can talk to people about Depression – or about mental health issues in general. But I left out a very important group of people. Kids.
How do you talk to kids about mental illness? How am I going to explain my Depression to the important children in my life? How do you explain it to those in your own? While people often worry about upsetting kids or frightening them by talking about mental illness – and I’m talking about the kids in your family or very close to you here; the facts indicate that most of the time children worry less about something if they understand it. Providing them with opportunities to talk and to find out what they think is happening is important. So is clearly and simply explaining what is actually happening in a way that they can understand.
But finding the right words to explain what needs to be said in kid language is a tough business. Plus, adults struggle to share their feelings. Again, accurate and age appropriate information are the best way to go – and this usually goes down best coming from a parent or another adult family member or close friend of the family.
So – how do you know when and how to do it?
If they ask questions about your or the other person’s health – this is a good opportunity. A number of resources suggest strategies like asking the child how they are feeling at the moment, if there has been an incident recently then perhaps ask them how they felt when such-and-such did this-or-that; or even if they thought you or the person were acting differently lately – depending on the age of the child. But whenever you do – pick a time and place where you’re all most likely to be comfortable and feel safe and where you won’t be interrupted.
It’s suggested that you explore the child’s understanding of what’s going on – not just accept their first reply because they could easily just repeat someone’s words without clearly them. Plus it’s important to know how they learned what they do know. Also, make sure that you’ve understood properly what they have told you.
Ask questions that are open – that is, they require the child to do more than say ‘yes’ or ‘no’. Try to get them to say what they think in their own words.
Be ready to reassure them. They might feel awkward. They might feel distressed or disloyal or angry or be afraid of causing worry or getting into trouble. Make sure they know that this is okay.
Now when you come to the explaining part:
There are lots of good resources take a look through some of them to prepare yourself for the talk or use them with the child. (Please see links at end of post).
Keep some coloured pencils or pens and paper or some play dough handy. Something that you can use to illustrate what you are telling them about or that you can ask them to draw something to help illustrate a point or a feeling. You may also write down thoughts or questions or plans together later (or draw their understanding of things for you when you are exploring what they know).
Think about examples of illnesses that children are familiar with that could be helpful in your explanation eg asthma, diabetes, broken bones, colds, chicken pox (some will depend on what they or their friends/family have had). Be specific in the comparison that you make eg asthma and depression both have triggers and physical signs even though they happen in parts of the body, both can seem to come out of nowhere … ; it is not like a cold because you can’t ‘catch’ it.
Or a common example is to compare the body to a car with different parts – different things work together to make the whole car work, but if something goes wrong then it can make the whole car run badly or not start. In the case of Depression … (a good example of such an explanation can be found in Talking to Children and Young People )
The big ideas to communicate no matter what are:
Mental illness is nobody’s fault
It’s not YOUR (the kid’s) fault
It doesn’t mean that the person doesn’t love you or care about you anymore
It is not your responsibility to make the person better.
You can’t “catch” it
Just because someone else in your family has it doesn’t mean you’ll get it
It happens to lots of people, in lots of families – not just this person
The person won’t be like this all the time
There are treatments like medicine and people to go to for special conversations and doctors who know about this illness
It’s not just about the person thinking or feeling differently. What is happening to the chemicals in their brain is different.
Here is a summary of an outline that I found about how to explain Depression to a child in an Australian COPMI program booklet.
Children can sometimes understand the impact of your illness more easily than they can its cause. This means that it may be best to describe what the depression does to you rather than what depression is.
So you might tell them that Depression can cause:
no energy (making it harder to play)
difficulty sleeping or sleeping too much (making it harder to get out of bed or keeping you up late at night)
crying a lot (sometimes when there is no apparent reason)
losing or gaining weight (because you don’t feel like eating or you eat too much)
not enjoying the things that you used to (means that sport or dancing or cooking or whatever it is doesn’t make you smile anymore)
make you tired and cranky (can make you get grumpy at the children for no real reason)
What does your depression make you do?
Depression is an illness. It’s like having a cold or having asthma except it affects your brain. Your brain controls the things you feel, think and do.
Everybody feels sad sometimes.
Everybody thinks bad things sometimes.
Everybody has things that they wish they could do, but can’t.
What makes your/this child(ren) sad?
What sort of things do they think about?
What do they wish they could do but can’t?
When someone has the illness called Depression, they can feel sad for a long time and not know how to feel better.
Depression can stop people being able to do things that they used to do and enjoy.
I hope that this gives you some ideas for some starting off points. Seriously – do take the time to check out some of these links. The first three have really informative and detailed guidelines in them. The resource lists include children’s storybooks, links and all kinds of things and the other links have some wonderful things in them too.
I have found some other FANTASTIC resources for parents, siblings, extended family and close friends of children who have parents (or family members) with a mental illness. Even one about babies for those with bubs or planning pregnancy. There are more out there just waiting to be discovered.
COPMI stands for Children Of Parents with a Mental Illness. It’s Australia’s national project over this area.
I do. Mine haunts me. I can never seem to beat it.
There are the odd occasions when I do really well against it and I win. It feels great. I could walk on air.
Sometimes they last for a short stretch of time – a few days, a week – two if I’m lucky. I could fly.
it all comes
And it’s not just me who is affected.
It’s not a small thing with small consequences.
What happens, you ask?
Okay I’ll ‘fess up.
I don’t wake up. Or if I do – I drop right off back to sleep before I can haul by backside out of bed.
Then I am late for anything that I have on for the day – visits, appointments, ….work.
And we’re talking regularly 30 – 40 mins late during the mid spring and autumn – and every now and then it’s a couple of hours. It affects other people when that happens – workers, patients … if I don’t get my work done it slows down the process of referrals going through, information getting to people in hospital and their treating teams for planning, people going home. It means groups can’t run or other people have to cover me. I nearly lost my last job over it. Even when well I’m often 10 – 20 mins behind my start time. I survive because I start before my boss and I always work back – but I can’t keep it up.
And it doesn’t seem to matter what time I ‘m supposed to start – I’ve adjusted starting times. It’s simply the process of getting out of bed and waking up in the morning.
Once I’m up, my sensory routines are helpful. I’ve started to experiment with some mindfulness exercises when I get time – which help a lot. But actually waking up and getting out of bed is jolly hard work.
The other thing that happens to me is that I lose time in the mornings. I do. Even when I’ve gotten up on time and have been running on time something happens – I space out in the shower or getting myself a drink and meds and time just vanishes.
I started a new experiment earlier this week that I think holds promise for the latter issue – I’ve started using a mindfulness breathing meditation exercise as soon as I get up that goes for about 10 mins to raise my level of alertness. If it keeps working at keeping me focused, I’ll be writing about that in a couple of weeks. But for it to work – I need to get up in time to have time to do it. It doesn’t need to be earlier – because I’ve worked out that I do everything else more efficiently when I do it. But I need to get up.
At present I use two alarm clocks set 5 mins apart – one to arouse my attention if I am in deep sleep so that by the time the second goes off I won’t sleep through it even if I sleep through the first. Part of me wonders whether it’s worth investing in a bed vibrating alarm clock – they make them for deaf people. It might be uncomfortable enough to help me move out of bed more easily. Has anybody ever used one?
I know the rules – go to bed early and get up and the same time every day. I’m awfully undisciplined at doing that.
Take your meds at the same time every day. I tend to get lazy and just take them on the way to bed – which admittedly is probably half of the problem. There are some very sleepy meds among my cocktail.
Every day is a new day with no mistakes in it – yet. Thank you, Anne Shirley – but other people remember and I need to work out the best way to deal with their memories and keep myself focused on the present so that I don’t drown in fright.
So here it is. My arch-enemy. The alarm clock. That moment in time that I’m supposed to get up. To get moving. To get started with the day.
Please – anybody with your own ghouls – what helps you haul yourself out of bed every morning?
There’s something centring about looking after yourself. Basic self-care. Hygiene and grooming activities. There are things among them that have qualities that can relax and alert us if we are mindful of what we are doing. A couple of posts ago I wrote about mindfulness and the senses in Send in the Senses . Today I would like to show you some of the ways that these principles can be integrated into everyday activities.
Warm water over the skin is relaxing. It’s soothing. You can just stand there under warm water in the shower or sit in a warm bath and let it calm you. (being conscious of your water consumption of course)
Or if you want to you can make it more soothing you can add a scented cleanser and smooth it on with your hands or a soft cloth. Then again – if you want to jazz it up a little, you choose a more uplifting stimulating scent and a courser cloth or a loofah. And okay – so the guys mightn’t be so into the scented soaps as the girls – but the rest still works as well for them even without the scents. On top of that are the sounds of the water and visual stimuli of the water running over you and the shower or lapping against the sides of the bath and the intricacies of your own bathroom and showering routine.
After washing, you think about how you are going to use your towel to dry yourself. Vigorous rubbing will invigorate the senses, while gentle strokes with the towel are likely to be more soothing. Alternately, you might wrap yourself in a towel or terry towelling bathrobe and wander around the house until you dry naturally.
If you’re looking for a basic activity that is inclined to stimulate the senses, then look no further than brushing your teeth. A toothbrush in decent condition with toothpaste on it brushed over the teeth and gums will arouse the senses of touch, taste and smell. Flossing is great if you’re anxious or need to slow down or focus because you have to do it deliberately and if you want to do it properly, you can’t do it quickly – so it forces you to slow down and focus your attention but gives you a task to do it with.
Painting your nails is great for the same reason. There is a need for controlled movement – so you need to slow down and focus your attention. Great for regulating anxiety. It is also something that can make you feel nice after you’ve finished. So nail painting incorporates controlled touch, slow and controlled movement, a stimulating smell – which is not necessarily why you’ve chosen the task – but it won’t put you to sleep. I was stuck in one city while the rest of my family were in another when my Grandfather died and I couldn’t be with them. I was very unwell with depression at the time and quite distressed. In the end, painting my toenails is what I did to calm myself down to a point where I could think reasonably. Then I could start to deal with my situation and emotions more logically.
For those who like a face mask – this is a beauty. Deep touch is relaxing, so you apply the mask with a firm touch. You follow the directions and wait while it sets, then when it is done you rinse it off. Now to rinse it off, follow the directions on the packet but remember: warm water – calming, cool water – alerting; and soft cloth and/or gentle strokes with firm pressure when rinsing will be calming, while a courser cloth and/or more vigorous or uneven strokes while rinsing will be more alerting. My own preference when using a mask is to rinse with a course cloth but gently with firm, smooth strokes in warm water.
If you need to shave, this is a good example of an activity that involves slow, deliberate movement. Focusing on the movement and the sensations of the shaver on the skin can be very effective. Most would find that this would alert touch and movement sensations, potentially smell also depending upon things like shaving creams and so on.
Another one – very touch and movement based that I find therapeutic at time is waxing. Great for anger management. Rip into the leg waxing. It’s systematic. You have to regulate it. You eventually slow down because the waxing process requires you to. But it’s also a useful buffer for stress, a way of alerting the senses to wake up when you’re weary or just getting rid of unwanted hair… Waxing is rich in touch (temperature, pressure etc), it involves controlled movement and you are using your sight to inspect your work.
Brushing or combing your hair can be either relaxing or alerting depending upon how you go about it, although if you use a comb it is more likely that the result will be an alerting sensation. When using a brush however, if one uses long smooth strokes the effect is quite different to brief, sharp strokes. The former is calming, the latter more alerting. Experimenting with different styles of brushing can be a great way to explore ways that touch influences the senses.
Think about all of the self-care activities that you do on a regular basis. Washing and drying yourself, washing your hair, styling your hair, cleaning your teeth, washing your hands, washing your face, moisturising, using deodorant, brushing your hair, shaving and/or waxing, cleaning your ears, dressing, cleaning your nails – anything you can think of … Take some time to think about what sensory qualities there are to the tasks. What movements, use of vision, scents, smells, touch, sounds, tastes are associated with them? How are you positioned for them? Where is your balance? Your centre of gravity? Which of these have alerting qualities? Which have calming ones? Are there qualities to any to the tasks that you do regularly that could be useful to you in other ways?
I have been reading a lot lately that has reminded me how frail humanity is. How vulnerable we are. Our bodies, our nervous systems, the balances of the chemicals in various systems that keep us functioning are so finely balanced. And so, so often is our sense of self. Our sense of our own competence and worth. We become vulnerable to so many thoughts and perceptions that we may once have never thought possible – may once have thought weak once this is penetrated.
I have been reading people’s writings – people who are feeling worthless, yet working daily at moving forward – at overcoming illnesses that sap energy and personal reserves like parasites. For as surely as I breathe Depression and Bipolar Disorder, Seasonal Affective Disorders, Psychosis, Schizophrenia, Personality Disorders and Anxiety are parasites that draw upon the heart and soul, the will and desire, the sense of purpose and confidence in one’s own capacity.
And yet as I read I see evidence that these illnesses and disorders are liars. I read words written by brave people who are still wrestling, still fighting, still entering the ring round after round. Sometimes they come out on top. Sometimes they come out feeling hopeless and defeated. But I say this. While people are still willing to step into the ring, they are not losing the war.
The human body, while fragile is also amazingly robust. We survive enormous things. Our bodies fight infections. It is well designed to protect its more fragile organs. It is our sense of self that is the fragile part.
Each person is unique.
Each person has a different combination of qualities – of strengths and weaknesses to the next.
Each person has something about them that is admirable. Worthy of respect.
Each person is entitled to dignity.
It is hard to breathe, hard to grow, hard to believe any of these things amid the lies of mental illness when it is out of control and where it has left its scars. It is hard to believe that friends still care when they are getting on with their lives while you are feeling stagnant and stuck wrestling just to keep your head just above water. If they haven’t been here they can’t possibly understand that you are feeling left behind. And so friendships grow fragile too.
Families tell us anything from we “just need to try harder” to telling us “not to push ourselves” because we’re too fragile. Sometimes they expect the world of us – and sometimes they seem to expect nothing at all. I’m not sure which is worse. Those who push too hard make us feel like we are inadequate and seem to think that we are just lazy – and that does wonders for our sense of self. Those who seem to think that we are too fragile to try don’t inspire hope that anything will ever get better although they mean well. How hard it is for a family to understand if they have never been here. They usually mean for the best – which leaves us feeling guilty for being annoyed by at their lack of understanding. How do we deal with this? Most of the time when we’re not well we’re not in a state where we feel eloquent enough to express ourselves well and we fear that it will all come out the wrong way. Sometimes it has before. And so some of us feel that our family is far from us.
And so we stand; feeling as though we could break at any moment. Our lives, our friendships, our relationships with our families, our very selves.
Hear me say – I believe that people who make it to this point can still be strong. Simply deceived.
Yes, your situation may be fragile. This does not mean that you are weak, undeserving of hope or inadequate.
You don’t have to believe me. You don’t have to believe it’s true as though you have had some kind of epiphany.
But treat the thoughts with the suspicion they deserve. Perhaps the same suspicion that you treat my claims. Keep stepping up for another day. Keep looking for tools to arm yourself with – mindfulness, sensory strategies, CBT, relaxation (see the link in today’s poll), self-affirming statements, support people, distraction, your medications – whatever is positive and works for you.
You too have strength within you. Even you – the one who doesn’t believe me yet.
An area that is starting to grow in mental health is an intervention called Sensory Modulation. It is used in a number of different ways and some people use it only in part. Some people may have come across ‘grounding techniques’ and ‘self-soothing techniques’. There is a cross-over between Sensory Modulation and distraction as a technique to deal with difficulties. It is a sub-branch within the world of Mindfulness and involves use of activity and engagement of the senses for therapeutic purposes. It is a big area for Occupational Therapists, Diversional Therapists and is starting to feature in Nursing literature, particularly for use in hospitals to try to find ways to reduce people’s levels of distress without having to resort to extra medication and seclusion. Studies are showing promising results.
Despite the way that we usually talk about five senses, we have actually have seven senses. We are used to thinking of our senses in terms of taste, touch, sight, smell and sound. However there are two more that we very rarely talk about.
The first of these is called proprioception. Proprioception is communication between your muscles and your brain. This is how your brain knows what your muscles are doing – when they are stretching, flexing and where your body is in space. It is proprioception that enables you to match the position of one arm to the position of the other with your eyes shut.
The second is a vestibular sensation. This is what gives us our sense of balance and the sense that we are moving in space like when we are in a car. It is also the sensation that gives us the feeling of dizziness and nausea when it is out of kilter.
Some people also differentiate between deep touch and light touch when working with the senses because your body often responds differently to the different types of touch. Think of the difference between being massaged and being tickled.
What is Sensory Modulation & how does it work?
Sensory Modulation involves using different types of activity or stimuli to calm or alert one or more of the seven senses. This in turn can feed into the way that a person is feeling or reacting to a situation, a stressor or the environment. So if feeling anxious and having anxious thoughts churning over through ones head someone might choose to do something that they know will engage the senses in a soothing way for them eg using a rocking chair, listening to music that they like that has a tempo of approx 60 beats per min whilst being mindful of the sensations; or they may choose to ground and/or distract themselves with something that alerts the senses and redirects their attention, perhaps using the tension in their muscles by going for a run or walk, again engaging awareness of the movement of the muscle groups and the engagement of the senses with the environment around.
Essentially, you take control of your senses and use them to serve your advantage.
Mindfulness & the Senses
Some of the ways that you can use your senses with mindfulness include:
Grounding techniques are active techniques to help you to orient and focus on the present and to distract or self-soothe when you’re feeling distressed. When you are feeling ‘out of sync’ they can help emotionally, physically, mentally and spiritually. If you know what you respond to best – you can even be prepared for times of crisis or for prevention if you are feeling triggered.
Some activities that people use to help ground themselves include
A hot or cold shower
Eating hot balls or sour balls, chilli, lemon – alerting tastes
Using a balance ball
Wearing weighted item eg back pack, ankle weights
Petting dog or cat
Warm or cold flannel to the face and neck
playing with a stress ball
Holding or chewing ice
Jumping rope or doing star jumps
Running or walking
clenching and unclenching muscles (isometric exercises)
playing drums or other musical instruments
Rocking in a rocking chair
Listening to music
Other activities that can be used for self-soothing or for orienting and alerting oneself capitalise on the calming and alerting features of the stimuli. Some examples of these include:
Calming Sensations Alerting Sensations
Hot shower/bath Cold or cool shower/bath
Holding/petting a pet Holding ice in hand or to face
Warmth of fireplace Being in a cool room
Wrapping in a heavy blanket Wrapping in cool bed sheets
Soft materials/textures Rough or prickly materials/fabrics
Rocking in a rocking chair A bumpy car ride
Swinging on a swing Spinning on a swing
Slow rhythmic motions Fast and/or jerky movements
soft/low lighting Bright or flashing lights
Decaf herbal teas Drinking coffee
Chewing gum Biting into an icy-pole
Chewy or crunchy foods/ lollies Sour or hot foods/ lollies
What to do with these activities – A bigger picture
The idea then is to consider the primary areas of difficulty that you encounter. Do you
Struggle with negative thoughts
feel triggered by something …?
Think about a) things that you can use to alert or distract yourself;
b) things that you can use to do to calm or comfort yourself;
c) things that you can do to help improve the moment; (something you enjoy, a treat, something to make you feel better)
Often you may need to do all three in that order – but not always. Regulating your reaction, however, may be more than a single step process.
What senses do you respond to most strongly?
Different people are more responsive to different senses. Some people love touch. Others squirm. Some love movement. Others enjoy scents. We’re all wired differently. How do you think you are ‘wired’? What are your preferred senses for comforting and alerting yourself?
Think about what kind of movement you enjoy (eg exercise, rocking chair, doodling, shopping, cleaning, theme park rides, skating, building, sports activities)
What kind of Touch & Temperature do you like (eg massage, sitting by fire, shower/bath, knitting, sunshine/shade, lotions, playing instruments, art, fiddling with things, doing your hair, heavy blankets/quilts)
What kind of auditory/listening stimuli you like (eg silence, running water, music, rain, relaxation soundtracks, wind chimes, theatre, a purring cat, people talking)?
What kind of visual stimuli you like to look at (eg scenery, photos, lava lamp, movies, window shopping, reading, fish in a tank, art)?
What kind of scents do you like or respond to (eg scented candles and oils, coffee, perfumes and aftershaves, flowers, fruit, herbal tea, fabric after being hung out to dry, chopped wood, forests)?
Think also about what kind of gustatory, tastes and chewing sensations you respond to (eg chewing gum, crunchy food, sour food, sucking a thickshake through a straw, yawning, deep breathing, listerine, blowing bubbles, hot balls, drinking coffee or hot chocolate, fizzy drinks, sucking a lollypop)
Making a Plan
When you have thought about the types of activities that you respond to. Make a note of half a dozen things that you think would be most helpful when you are distressed.
Why not set aside a place or a kit where you have some if not all of those things ready to go and on hand when and if you need them?
Knowing how your senses work can help you tap into them better for relaxation, recreation and for giving yourself a jolt if you need one. I have found ideas from studying this stuff that are great for my recreation, rest as well as helping me when I am worked up or struggling to focus. I hope that it’s useful to you also.
If you are interested in more information, information about making a sensory kit or a questionnaire about your sensory profile, please leave me a message in the comments and I will get something back to you.
(Credit to a lot of the lists goes to a combination of published resources that I have referred to, some of which have no author attached, majority of examples listed resourced from Tina Champaign’s website)
I live with a black dog. It follows me everywhere. My philosophy now is that I need to plan for its needs when I plan for my own. I also need time out and restful places to enjoy the warmth of the sunshine on my shoulders.