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?
The black dog had been pulling at the lead all week.
My work satchel was dragging down on my shoulder.
I was walking towards Woollies to buy the makings for dinner.
Then I saw it.
The massage therapy place in the shopping centre.
It was clean.
It was respectable.
It was affordable … with minor adjustments
And it was THERE!
And in only a moment so was I.
“Do you have an opening?”
There was an opening.
What did I want?
“Upper back, shoulders & head please.”
Back, shoulders and head I got.
I went in with my muscles aching, my shoulders set like concrete and my neck so tight that I’d not been able to comfortably look over my shoulder in days.
I came out uncrimped and able to move.
I happened to be lucky last week. I had a little money that I’d not budgeted on having. I couldn’t always just do that. Besides, I’m not usually the type to let someone I don’t know give me a massage. (Seriously, if you’d heard me coming on Thursday you’d have gotten out the DW40 ready to get rid of the creaky noises when I arrived)
The problem is, however – I have trouble getting a massage at all. Most of the time it doesn’t bother me – but when I say “massage” around my family and friends, they all turn around and say, “yes please!”
Yep, you’ve got it. I’m the one who grew up with the sooky Dad. The one that played sport too hard too far into his 40’s and 50’s and then moaned about the aches and pains all week. I was trained to massage my father’s legs when I was six or seven … and I am not exaggerating. There is no need.
My brother, who had once helped, grew callous and demanded payment at some stage, but I was still too gullible to get out of it – or figured it was easier to put in 5-10 mins of back or head massage than to listen to him grovel until he gave up. In the end I got to be not too bad at it and when I hit Uni and somebody taught me anatomy, I actually became quite good. Now, this was all fine and dandy for the family and the friends – but it did bugger all for me.
I’ve tried to interest some of them in learning, but do you think I’ve had any success?
The thing is – it’s not that hard to give a passable shoulder massage that will make someone very happy that you took a few moments out of your day to share it. There are only a few basic principles that you need to follow – and these are consistent pretty much anywhere you massage.
Apply pressure in long, slow, firm strokes.
Start light and increase pressure slowly over time.
If you’re worried about whether you’re working your strokes to quickly – slow them down, just keep your pressure even.
Except with specific muscle groups, plan to work the muscle along the grain of the muscle fibres ie the direction that the muscle goes.
Work from the surface muscles toward the deeper ones.
Always stay away from the spine, throat and other sensitive areas.
If it causes pain – stop.
Here is a rough picture of some of the muscles of the back:
If I were looking to spend five or ten minutes just helping someone to unwind, I might start by finding the bony landmarks on the person’s back and think about where the muscles are in relation to those bones. The spine is usually visible down the centre of a person’s neck and back. The easiest way to locate the shoulder-blade is to start at the tip of the shoulder and to trace it around with your fingers. Notice that the shoulder-blade has two bony borders along the top. This is because it’s not shaped only like the 2 dimensional triangle that you see in drawings, it has another edge – a bit like a fin (but not quite).
So, say a person is sitting in front of me – here I start by running my hands straight up the back to the neck one after the other, avoiding the spine and moving from the centre to the edge – first on one side, then the other.
I then follow this by focusing on the muscles coloured red and green on the left hand side of the illustration – initially the red Trapezius muscle which is large and often carries a lot of tension. I would massage predominantly in the direction of the arrows – in upward strokes along the muscle fibres.
After these muscles have been freed up a bit and feel less tense, then I might move my attention to the deeper muscles. If the muscles are not freeing, I would turn my attention to the blue muscle – Latissimus Dorsi. A person’s lat’s are large and often carry a lot of tension also, so you may need to break up some of this to get anywhere with the Trapezius. When working the Lats, I use a wide surface of my hand or forearm with long firm, upward and oblique strokes and then smooth them down and go back to the Traps again.
By now the person’s muscles are warmed up, so they are also tolerating firmer pressure as I target deeper muscles and the upper muscles are relaxed enough so that the pressure reaches them. The principles for the muscles of the deeper layer muscles are pretty much the same as the ones I use for the upper layer ones. The only exception is that I will often spend some time after warming up the Rhomboids (pink) working them across the grain of the muscle (ie across the muscle fibres, not along them because the Rhomboids get really, really stiff sometimes and need help to free up).
The other muscle to have a good look at that people love having worked is the Levator Scapulae. Again, just work it up the grain of the muscle fibres. It’s also helpful to just press on it at about the base of the neck for a few seconds or so. Also working the muscle inside the triangle at the top of the scapula is easier once the muscles are warmed up.
But if the deeper muscles look too confusing, don’t worry – even if all you do is loosen up the upper layer of the person’s back – most people will thank you.
What part of your hand you use is up to you – I often knead with the flat edge of my thumb while I rest the heel of my hand on the person’s back. I might sometimes use the heel of my hand to massage. Depending on the person and how long I have been massaging for I may gently use my knuckle. You can also use your forearm.
None of the stuff I’ve shared today is particularly scientific or text-book. Simply hands-on learning. But I think that people being able to help each other break up muscle tension is worthwhile. So is nurturing.
When it comes to massage, all I can say is that lots of people like a treat. See if anything that I have learned adds anything to what you know – and please … you’re welcome to share your tips with me.
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 don’t know about you, but I was very sceptical about relaxation exercises for a long time. I would always think back to school days when guidance counsellors would take us through guided imagery sequences featuring a calm blue ocean or some such scenic place and tell us how we relaxed we were while the class clown made farting noises, his followers giggled, the teachers reacted and everyone else just rolled their eyes and waited for the session to finish. At other times, attempting to relax has been more stressful than relaxing because the facilitator just wasn’t on the same wavelength as me. I find it annoying when that happens.
It took a long time to realise that relaxation was a skill that required practice. It has taken longer still to discover that there are many different types of relaxation exercises that you can do. Recently while looking for a site for someone, I found one that had a variety of sound tracks for relaxation exercises ( http://www.allaboutdepression.com/relax/index.html ). I decided that I would sample all of the relaxation exercises on this site to see what I thought of each of them – to give each a chance. Today, I’d like to share with you a little about the exercises that I did and my thoughts on each.
I thought that these were very useful. Each of them was effective, and they were particularly effective when used in series. The educators recommended that for those with anxiety disorders, your levels of anxiety will reduce by doing breathing exercises regularly as maintenance – and I can believe this given the difference that it made in the amount of tension in my body.
For those who do not have anxiety – like me … I did my mood diary scoring after I did relaxation exercises and my scores were significantly higher than they had been on any of the recent days leading up to these times. I have been experimenting recently with http://www.moodscope.com which is a computer based system – so I was not simply giving myself a better score out of 10.
Progressive Muscle Relaxation
Progressive Muscle Relaxation is a favourite of mine. It essentially involves tightening a group of muscles, holding them tight and noticing the tightness, then releasing the tension entirely and noticing the absence of muscle tension. You then systematically work through to the next group of muscles and do the same thing.
I will usually start with my toes, progress to the soles of my feet and calves, the upper foot and shins, my thighs, my butt, then my hands, wrists and arms, elbows and biceps then shoulders; then I go back to my trunk and tighten and release my abdomen, then lower back, upper back, chest, shoulders (again), front of neck, back of neck, tilt neck left then right, then I work through my face so my forehead, nose, cheeks, mouth, jaw and tongue (pressed against the roof of my mouth). Then I finish by either breathing exercises for a while or by standing and shaking out my arms and legs and stretching. But that’s me and that takes anything from 10 to 20 mins depending on how many repetitions you do of each muscle group. Sometimes for really tight groups, I’ll repeat the actions a couple of times eg shoulders.
The progressive muscle relaxation sequence on the All About Depression site goes for 8mins40sec and is nice and efficient while still covering what needs to be covered (http://www.allaboutdepression.com/relax/pmr/pmr1QT.html ). I found it satisfying and was pleased with the result at the end of the session.
I need to be frank here and admit that I am not someone who is a great fan of guided imagery sequences. I find someone else’s descriptions of a place that they think should be relaxing for me to be kind of distracting. I’d much rather be left to breathe or if there needs to be an image, then I’ve done sequences where the person guiding the sequence has left room for the person relaxing to select a place they like and guided by asking questions like “what can you see?”, “What can you smell?”, “Look around you and explore the colours.” I found that kind of guided imagery more engaging.
I came to this exercise expecting it to be grossly annoying and to loathe it. It was actually one of my favourites. I’m not sure whether it was because of the sequencing of the exercise, or the conscious repetition of phrases (I repeated most of them in my head because I found that doing it out loud made it difficult to breathe deeply and evenly), but this exercise really worked for me. I want to go back and learn the phrases and the sequence to use at any time. http://www.allaboutdepression.com/relax/phrases/phrases1QT.html
Mindfulness Oriented Relaxation Exercises
Mindfulness is about being ‘just in the moment’. In this context, the relaxation exercise is about focusing oneself on relaxing just into the moment. A lot of the rationale for this is that a lot of distress occurs surrounding things that have already happened or have not happened yet and that sometimes the sadness, anxiety, pain or negative feelings are easier to bear in the immediate moment if we are not contemplating past or future at that point in time.
This is one of my favourite relaxation exercises. It starts out with breathing, then gradually asks you to notice things with your other senses, in particular where your body has contact with other surfaces, the feel of your clothes and the sense of the weight of your arms and legs as you’re supported by your chair (in my case) or where ever you are resting. I loved the sensation of my clothes on my skin as I was breathing – I was wearing a particularly soft shirt the day that I did the exercise for review. A definite must in my books (http://www.allaboutdepression.com/relax/mindfulness/mm21QT.html ) although regulars will know that I’m a fan of mindfulness as a strategy in general.
Mindfulness with Guided Imagery
Remember what I wrote earlier about guided imagery? Well it’s no less true where the imagery is attached to mindfulness strategies. That said – in the first exercise Sending Thoughts Away on Clouds (http://www.allaboutdepression.com/relax/mindfulness/mm31QT.html ) I found the clouds a great way to dismiss unwanted or intrusive thoughts – the idea being that where a thought that was a distraction from the scene or your breathing came into your consciousness, you were to send it away on a cloud. I could picture this as though just blowing the thought away. Sending Thoughts Away on Leaves (http://www.allaboutdepression.com/relax/mindfulness/mm41QT.html ) didn’t feel as natural, although it kind of worked. In this guided image I was taken to a clear forest stream to enjoy it.
The final image was quite different in what it did with distracting thoughts. In this the idea was to be Sorting Into Boxes (http://www.allaboutdepression.com/relax/mindfulness/mm51QT.html ) thoughts that intruded, the boxes being one for thoughts, one for emotions and one for sensations eg aches and itches. This was more bizarre to start with and I found myself distracted by the boxes – but after a while I settled down and just focused on my breathing again and that helped. For a while however, I think I was almost inventing itches and filing the thought ‘this is stupid’ over and over again. Once I went back to breathing and visualisation the boxes became background scenery – a bit like a picnic basket when you’re not actually eating. I can imagine this being helpful though if you were being flooded by intruding thoughts and feelings – you could just label them without processing them and put them to the side by the rules of the exercise without it being an intrusion on what you’re supposed to be doing – which is staying in the moment, just breathing and picturing a scene.
MY TOP 3
My favourite three out of these audio tracks in no particular order would have to be:
Progressive Muscle Relaxation
Why not take the time to try a few? What were your favourites?
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.