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Do You Tell Your Boss? 13/11/2011

Filed under: Clinical Depression,Depression,Experiencing Depression,Explaining Depression,Function,Managing Depression,Work — jillnottelten @ 11:28 pm
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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.

Never disclosing

Why you might …

  • Protection from gossip and discrimination.
  • Protection of positive image and opportunity
  • Privacy
  • Stable health
  • 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.

I have included in the Fact Sheets menu this week a document called “Choosing Your Path.  Disclosure: It’s a Personal Decision“.  It’s about disclosure of ‘disability’ (or illness) in education and training after High School and employment and the processes of application, entry and engaging in the roles.  The booklet discusses legal issues, reasons why one may or may not disclose at various stages of training or employment, responsibilities and some of the considerations to ponder in making your decision.  Also have a look around the Beyond Blue website as they have a number of resources for work sites and managers as well as fact sheets about telling your employer about your illness and maintaining good mental health for tertiary education students.  Lastly, I have listed a book called “Tackling Depression at Work” in the Books menu.  I’ve not yet read this one, but it was written by reliable people and has been well reviewed so should be worth a read.  I have listed the book at the publisher’s site, you may or may not be able to find it cheaper elsewhere if it interests you greatly.

 

Senses of Self Care 29/10/2011

Filed under: Depression,Experiencing Depression,Mindfulness & the Senses,Routine,self-management strategies — jillnottelten @ 8:00 pm
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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?

 

calm blue ocean … Calm Blue Ocean … CALM BLUE OCEAN!!! 28/10/2011

Filed under: Depression,Function,Managing Depression,Mindfulness & the Senses,Physical health & wellbeing,self-management strategies — jillnottelten @ 8:16 pm
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Now this is exercise

Now this is exercise

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.

Basic Breathing Exercises

Breathing exercises have been proven to be great for managing anxiety.  If you suffer from anxiety and have not already worked on some form of breathing exercises, may I recommend that you start here.  It is simple.  It is easy to follow.  It’s long enough to get a feel for what you’re supposed to be doing without being so long that you feel like you are going to be chained to the computer forever.  Furthermore the first three exercises are all breathing exercises that build upon each other.  You start with Diaphragmatic Breathing ( http://www.allaboutdepression.com/relax/diaphragmatic/diaphragm1QT.html), move on to Deep Breathing 1 (http://www.allaboutdepression.com/relax/deep1/deep11QT.html ) and then Deep Breathing 2 (http://www.allaboutdepression.com/relax/deep2/deep21QT.html ).  You don’t need to be able to do all three, but I would recommend doing the diaphragmatic breathing before any of the other exercises because it does help.

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.

Guided Imagery

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.

There are two different sequences on the All About Depression site, one set on a beach and another in a forest clearing.  I think that I liked the second best in this case.  (http://www.allaboutdepression.com/relax/beach/beach1QT.html ,  http://www.allaboutdepression.com/relax/forest/forest1QT.html )

Relaxing Phrases

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.

Just this Breath

This exercise focuses upon observing your breathing.  Not changing it, simply observing it in the instant that it is happening.  It is difficult to get the hang of, but very rewarding and worth the effort.  Definitely worth a shot.  http://www.allaboutdepression.com/relax/mindfulness/mm11QT.html

Increasing Awareness

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:

Increasing Awareness

Relaxing Phrases

Progressive Muscle Relaxation

Why not take the time to try a few?  What were your favourites?

 

How Frail Humanity 26/10/2011

Filed under: Clinical Depression,Depression,Experiencing Depression — jillnottelten @ 4:17 pm
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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.

 

Send in the Senses 23/10/2011

Filed under: Clinical Depression,Depression,Experiencing Depression,Function,Managing Depression,Mindfulness & the Senses,self-management strategies,Therapies — jillnottelten @ 8:30 pm
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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.

The Senses

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

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
  • Breathing exercises
  • Yoga
  • Using a balance ball
  • Cleaning
  • Yard work
  • 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
  • Aromatherapy
  • Moving furniture
  • Holding or chewing ice
  • Jumping rope or doing star jumps
  • Stretching
  • Running or walking
  • Lifting weights
  • Push-ups
  • clenching and unclenching muscles (isometric exercises)
  • playing drums or other musical instruments
  • Pottery
  • Rocking in a rocking chair
  • Dancing
  • Listening to music
  • Waxing
  • Journaling

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

Massage/Deep pressure touch                                                      Light touch

Isometric(the muscles don’t move) exercises/yoga              Aerobic exercise

Leisure walks                                                                                         Power walks

Dusting powder/powder puff over your body                        Rubber band wrist snapping

Slow/rhythmic music                                                                        Fast paced/upbeat music

Calming sounds of nature eg ocean                                             Alerting sounds of nature eg birds

Humming/singing quietly                                                               Humming/singing loudly

Soothing scents (oils/lotions/candles)                                     Strong scents (oils/lotions/candles)

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

  • get overwhelmed
  • get voices
  • Get angry
  • Get anxious
  • Depressed
  • Struggle with negative thoughts
  • Feel disconnected
  • 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)