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Supporting People with Anxiety, Using Sensory Integration and Other Strategies

Submitted by Guest authour Jane OT

As I read the recent article “14 Phrases Kids Said That Were Code Words for ‘I’m Anxious from The Mighty, It felt familiar – like I had met every one of these responses to anxiety and not just from children.

 “What’s wrong with me?”… “I’m tired.” … “Can’t we stay home?”

“I don’t feel well.”

Anxiety affects so many people and they are not all confident naming and talking about it. Some may know they are anxious but be embarrassed about telling people, for others, it may be that long-term anxiety is new to them and they haven’t really grasped that the physical symptoms are related to their anxiety.

So how does anxiety play out in real life and how can we help?

The elderly lady who has had a reduction in her mobility now feels sick when she goes in the car (but her doctors can’t find anything physically that would cause this), may not understand that her body and brain has become accustomed to less movement and so is less able to integrate vestibular stimulation with other sensory stimulation hence she feels sick now avoids leaving her chair for fear of some as yet unidentified illness but is embarrassed to say she feels scared. Her fears about illness then generate yet more anxiety symptoms e.g. Feeling sick racing heart and more, confirming that she really has got some mystery illness that the doctors are missing, so she avoids leaving her chair whenever she can. This leads to a further loss of integration between her senses as she is not moving much (vestibular) and she is not using her muscles much (proprioception) and will eventually lead to loss of function.

Or that friend who is always tired or busy when you want to go out (there might be other reasons) and cancels at the last minute. But to be honest, as a mother to a lovely but anxious young lady it is the young people who concern me most

My concern for young people is driven adult-cute-face-female-41522by the knowledge that the young brain is primed to learn (Jenson 2015)… And learn it will – either good things or less good things, so if like the elderly lady the young teen avoids activities there is a good chance that these coping strategies will become an ingrained life pattern.

So what can we do to help?

  • First get to know the symptoms of anxiety there are numerous self-help books and Web pages e.g. The NHS Web site, Web MD, mind etc.
  • Second help the young person to choose activities that are likely to reduce anxiety… From a sensory integration perspective, these are likely to be ones that involve heavy muscle work and muscle stretch (proprioception) and ones that make the young person think like Martial arts, dance, rock climbing gymnastics etc. Will be better than just proprioception alone. We do dance and acrobatics.
  • Consider 1 to 1 tuition if they need to gain skills to catch up with their peers… But if you do this it’s good to plan to reintegrate the young person into group lessons… So that they can deal with social anxieties. We went to a group lesson and it was clear my daughter had a lot to learn so we had a year of individual lessons (and still supplement the group lessons with the occasional individual lesson). But then we went to group lessons, it took half a term but now she is enjoying doing acrobatics duets which brings me to my next point.
  • Make sure the young person attends regularly and on time for a good chunk of time…..
    Be prepared for ongoing anxiety and be firm that they go… My daughter frequently tells me on the way home “oh sensory mum you’re right I do feel better.
  • Try to avoid surprises… We have a wall planner for the term and all activities are written on it… And I have noticed my daughter (and I am) much calmer knowing what needs to be done and when.
  • Discuss and consider professional help… Some Ayres’ Sensory Integration trained occupational therapists use other techniques in conjunction with their sensory integrative therapy, others will work alongside mental health professionals and for some people, Ayres’ Sensory Integration therapy will be enough on its own.
  • You may also decide to work through a self-help book and this can be a good option… But if in doubt always consult with your GP or/and any other health professional who is working the young person.

So what about those adults… Its a little different to the young people but listening and understanding or trying to understand is a good first step. Giving them information about sensory integration and mental health issues can also be helpful. Then asking them what they want you to do and staying in touch with them even if it’s difficult. And always remember it’s never too late for someone to get help.

what anxiety loks like

Reference The teenage brain by Frances Evans Jenson. L

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The Teenage Brain and Cannabis

Recent research from Tel Aviv University suggests that smoking cannabis can trigger schizophrenia.

The study provides evidence that in susceptible young people, smoking or using cannabis trigger schizophrenia. Susceptible young people include those for whom there is a familial history of mental illness.

Reference: Hadar Segal-Gavish, Neta Gazit, Yael Barhum, Tali Ben-Zur, Michal Taler, Shay Henry Hornfeld, Irit Gil-Ad, Abraham Weizman, Inna Slutsky, Minae Niwa, Atsushi Kamiya, Akira Sawa, Daniel Offen, Ran Barzilay. BDNF Overexpression Prevents Cognitive Deficit Elicited by Adolescent Cannabis Exposure and Host Susceptibility InteractionHuman Molecular Genetics, 2017; DOI: 10.1093/hmg/ddx139

You can read hear more about cannabis and the adolescent brain here:

 

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The Teenage Brain – Can neuroscience help us unravel the perplexing mystery of those often erratic and unpredictable years?

The teenage brain and the behaviours it can drive in young people can be perplexing and often scary to the parents standing by, watching and supporting. Knowing” what is sensory and what is “just teenage brain” can be tricky to parents of young people with neurological diversity.

Neuroscience is helping us understand why teens can suddenly engage in extreme, rollercoastering unpredictable behaviours that challenge those caring for them.

Here is a lovely youtube explaining some of the neuroscience behind these often turbulent and troubled years.

Tomorrow at 6pm we will be exploring The Teenage Brain and Cannabis

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Sensory Ladders

The first Sensory Ladders were made in 2001 for adults with sensory integration difficulties receiving help with mental health difficulties in Cornwall. Influenced by the paediatric Alert Program, they offered therapists a way to combine Dialectical Behaviour Therapy and Ayres’ Sensory Integration, addressing the development of the person’s self-awareness in collaboration with ward staff on an acute psychiatric inpatient unit.

The need to start with the person where they are at, before introducing learning about new ways of being, including the development of new skills, made it necessary for the Sensory Ladder to remain a very individualised and personalised journey within a close safe therapeutic relationship.

Both Ayres’ Sensory Integration(ASI) and Dialectical Behaviour Therapy(DBT) share a common understanding that development and change can only occur within a safe environment. The DBT idea of balancing safety and challenge reverberates strongly with Ayres’ concept of the ‘just right challenge’.

Creating a Sensory Ladder is about creating opportunities for an adult or child to learn to become aware of themselves in a new way – to explore and discover new things about mind, body and brain. It allows the therapist and person to do “curious wondering” together, and for the person to try new things – creating and promoting active but informed risk-taking; testing how we might feel and experience something when we do it differently; new ways of being – new ways of responding.

Making and using a Sensory Ladder is about the journey together within a safe therapeutic relationship. It’s about getting to see and know someone in a very different way, getting underneath the skin of behaviours that are perhaps being described by others as tricky or challenging.

The Sensory Ladder facilitates the reframing of behaviour that are a result of sensory integration challenges, providing the first step of acceptance of the behaviour necessary before strategies and therapy support development and change to happen.

To see more Sensory Ladders, visit our Sensory Ladder FB Page

 

https://.www.sensoryladders.org.

Pokemon Sensory Ladder copy

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Changing lives with trauma; Sensory Ladders, Sensory Strategies and Ayres’ Sensory Integration

Last week I found a copy of a therapy review that a young person wrote a few years ago.

“My sensory me is about me – and only me. It’s not about anybody else. It helps me be me.  I don’t worry about what other people think I should be. I am starting to like me now. I’m not so sad anymore. Knowing why I’m different helps me to not worry anymore, and it means I can say what I need.”

He continued “before people told me what to do and how I should feel, and what I needed. It didn’t match up with what I really wanted. That confused me. It made me worry because I kept being wrong. When I did things, people didn’t understand what ‘made me’ do these things. I could see that, but I couldn’t understand why.

I loved therapy and all the stuff we could do. Making safe spaces on my first session helped me know you really knew what I was feeling inside. That was a bit scary. It was like you were a mind-reader. Then I got to know it was because you know about the brain and the senses, and you watch a lot. We did lots of experiments to discover how my body works. I liked that. All the stuff we got to use, the big golden hippo, barrel and all the swings. I loved playing Harry Potter with you – with the golden snitch, the hats and the magic wand. The swing was my fantastic flying broomstick. It was the best part of all. I liked to ride it with my cat.  I really liked bouncing on the mattresses and trampette. And the hot chocolate with cream was the best.

It’s different now. I can stop and wait to find the words. Then I check it out. I have much less meltdowns. My Sensory Ladder helps me explain what is going on. I use it with my new Mum and Dad, my new Gran, my teachers and even my friends know that when I am a techy scratchy cat, then the snarly spitting cat is not far away and I need a sensory movement break.

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And because of therapy, my body knows more now. I get it right more. I think I am just able to do everything easier. My new friends understand me better now. I don’t always get it right everytime.e, but it is better than ever before. I am calmer, clearer and concentrate better. I even join in with Netball now. My room is tidier now, and I can finally have shoes that have laces.

Thank you for helping me learn about how my brain is changing all the time.  It means I didn’t have to worry about how it was wired. I could just work on making new wires ready for my new life.

In the beginning, therapy can be really scary. You don’t want anyone to know what is hard. The book we used to get to know more about my senses helped me know it might really work when I didn’t know it would.”

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Here is a copy of the James’ My Sensory Me document including his sensory strategies – made during OT sessions. We made his Sensory Ladder together so others would know how to help and support me at school and home. He used it and practiced telling people his story until he didn’t need to use it anymore.

His Sensory Ladder was printed off and made into keyring sized tags to attach to his pencil case, his Foster Mum’s key ring with copies on the fridge at home, on his desk at school and a copy went to his first visit with his forever family.

“Our Harry Potter Therapy was the best thing I ever did and I will never forget it. I believe in the magic.”

The first Sensory Ladder was made in 2001. It is reported in articles published in 2006 and 2009.

1. Brown S, Shankar R, Smith K, et al. Sensory processing disorder in mental health. Occupational Therapy News 2006; May:28-29.

2. Brown SShankar RSmith K2009Borderline personality disorder and sensory processing impairment. Prog Neurol Psychiatry 13:1016.

Thank you to James’ and his forever family for allowing me to share his story, with a few changes made to protect his identity.