Archive for Therapeutic Brushing

Therapeutic Monday

April 20, 2009 Rachel Hearing, Occupational Therapy, Sensory Processing Disorder (SPD), Sensory Processing Issues, Therapeutic Brushing, Therapeutic Listening

The Therapeutic Listening program is going very well for me, and I’ll share some experiences below. At the end of my post, I’ll also have some information about a possible alternative to Therapeutic Brushing.

But first, today’s visual.

To explain the difference between how neuro-typical people and Aspies handle sensory input, Tony Attwood employs the images of a bucket and a cup. Our neuro-typical friends, he says, have a sensory bucket, capable of holding a great deal of sensory information. Those of us on the spectrum, however, have a much smaller vessel—a cup, which gets filled a teensy-bit more quickly.


Just before Passover, my husband made an offhand comment about my sensory vessel being a thimble. At work the next day, I just happened to run across a very nice ceramic thimble. I put it on our seder table as a reminder. So here is my sensory vessel, photographed next to a very small bottle cap for scale.

And now, onto the therapeutic ways I am attempting to replace a thimble with a cup.

Therapeutic Listening
So far, I am able to listen to the CD for 30 minutes/day while lying under my weighted blanket. I generally fall into a deep sleep after a half hour of listening, and I wake up an hour later wondering what day it is. I don’t think that’s the primary purpose of the exercise, but I appreciate it nonetheless.

In terms of intended effect, I am seeing some small progress already. For example, at work the other day, I was looking at some clothing. To my left, a staff person was talking excitedly with a friend she hadn’t seen for awhile. To my right, a man was laughing loudly over an outfit that two women wanted him to put on. I had the following reactions:

1. I was not jarred or annoyed by the man laughing loudly, even though he was only about 6 feet away from me. In fact, I smiled to myself. Weird, but true.

2. I did not experience both conversations in stereo. I tuned out the first conversation because I was enjoying the laughter in the second conversation.

These responses are highly unusual. I generally get very irritated by loud people. And it’s almost always impossible for me to tune out one conversation in the service of another. I was able to do so at the store because only two conversations were going on in an uncrowded space. With more people, in closer quarters, all talking at once, I still hear everything at the same volume—the one marked “Very High, and Why Do You Look So Alarmed?”

I also noticed that I was able to pick out a line from song that I’d been listening to for weeks. I have a terrible time hearing song lyrics, but all of a sudden, this one line just sounded loud and clear. Kinda cool.

In general, I’m becoming more aware of the effect of sound on my nervous system. Usually, I’m so fascinated by visuals that I don’t really notice my body’s response to sound until I’m overloaded. But yesterday, when my husband and I were going out shopping, something changed. As we were walking down the street, four guys driving VERY LOUD Harleys drove past us and gunned their engines as they were idling. (Don’t you hate that?) My first response was to feel very angry, as though they were gunning their engines just to piss me off. Then, I noticed that my ears and head felt assaulted, and that my stomach was churning. After the motorcycles were gone, I stumbled over to the nearest wall and tried to catch my breath. When we got into the sneaker store (which was pretty quiet and calm), the stomach churning stopped.

So, some small (but welcome) progress on the auditory front.

An Alternative to Therapeutic Brushing
A friend in Minneapolis, who is an OT, wrote to tell me about an alternative to Therapeutic Brushing. It’s called “hand hugs,” and consists of someone using their hands to apply pressure to the arms and lower legs. I’m told that it’s a powerful technique, so do not try it without an OT showing you how to go about it. Apparently, Therapeutic Brushing does not work for many people, so if you’re having difficulties with it, hand hugs might be an alternative. I am going to ask my OT about it the next time I see her.

And now, I’m going to go take a nap…I mean, listen to my Therapeutic Listening CD. :-)


© 2009 by Rachel Cohen-Rottenberg


 

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My Second OT Visit

March 29, 2009 Rachel Making Art, Occupational Therapy, Sensory Processing Disorder (SPD), Sensory Processing Issues, Therapeutic Brushing, Vestibular System, Weighted Blankets, Weighted Vests

Note: For information about my first OT visit, see my previous post.

For my second appointment, I showed up slightly less of a wreck than I did at the first, but still in need of some grounding. This time, the OT used the Thumper, a big vibrating machine that she ran back and forth over my back. The vibration was so strong that I could feel it inside my ears. It was another piece of heaven.

Once I got more grounded, we talked about how the past week’s activities had gone and discussed new activities to try in the coming week.

Therapeutic Brushing
After hearing about my negative experience with the brushing, the OT agreed that I should discontinue it. Instead of the brushing, we tried using soft bean bags and tapping them on my arms and legs. It felt okay at the office, but when I tried it at home, it felt distinctly like hitting myself, which is a trigger. She had also mentioned that I might try using a soft fabric that I find comforting. I have tried using the velvet fabrics I have, and they feel okay on my arms, but I still resist the whole activity. Trauma stuff, I think. Anyway, I do what I can.

Drawing an Infinity Sign
When I told my OT how frustrated I felt drawing the infinity sign, she suggested that I just imagine a large one on the wall and track it with my eyes. I’ve been doing that every day, and it feels really great. I can actually move my eyes without moving my head! After 50 years of doing it the other way, that really amazes me. I even find myself playing around with the exercise at work. I’ll look at something, and then shift my eyes to another object without moving my head. Everyone is so busy looking at all the objects in the store that no one notices the strange woman in the linen department doing eye exercises.

Learning the Cross-Crawl
At this visit, my OT taught me something called a “cross crawl,” in which I lift my right hand and then use it to touch my upraised left knee, and then use my left hand to touch my upraised right knee. The point is to cross the center line in my body in order to get comfortable with the parts of my body working independently. I find this particular exercise very easy, as it reminds me of various karate exercises that also work with crossing the body’s center line.

Singing
After hearing that the vibrations from the Thumper felt like they were inside my ears, the OT told me to sing every day. She said the vibrations would help to activate and soothe my vestibular system, which controls balance and movement, and is based in the inner ear. I always sing when I work out anyway, so this has been an easy one to practice each day. I also want to relearn Torah cantillation. In fact, the book and a small keyboard have been sitting in my loft, beckoning me for months. I’m hoping to add cantillation to my OT routine at some point.

Proprioceptive Activities and Late-Night Snacking
As I mentioned in an earlier post, the propriocetive system provides information about the relative positions of the parts of the body. Engaging the proprioceptive system includes how we feel the joints in our body and the kind of pressure we put on them. The right amount of pressure is very soothing. 

I find that I do a number of activities to engage the proprioceptive system, such as using a weighted blanket and weighted vests, bicycling, taking walks, doing my artwork, and fidgeting with whatever object is handy. I wondered whether my tendency to eat a lot before bedtime is also related to my need for proprioceptive activities. My OT said that chewing on things engages the joints in the jaw in a powerful way, which is why I like chewy, crunchy things at bedtime. I’m using them to calm myself down.

I don’t particularly like using food for this purpose on a regular basis, and she suggested that I try a different proprioceptive activity when I feel food cravings without being hungry. It’s going to take a while to work out of the habit of using food to calm myself at night, but the amount I eat seems to be diminishing as I do other activities. Last night, for instance, I spent some time doing my artwork and ended up eating a lot less than usual before bedtime.

When all is said and done, I’m enjoying the process of occupational therapy. Because of my executive dysfunction, I’m still having difficulty consistently working the exercises into my daily routine. But I’ll get there.

2009 by Rachel Cohen-Rottenberg

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My First OT visit

March 29, 2009 Rachel Gravitational Insecurity, Occupational Therapy, Sensory Processing Disorder (SPD), Sensory Processing Issues, Therapeutic Brushing, Weighted Blankets, Weighted Vests

Since my sensory assessment, I’ve had two visits with my Occupational Therapist, and they have been unlike any visits I’ve ever had with a health professional. No matter what state I’m in when I arrive, I know that she will offer me ways to ground and to feel held.

For my first appointment, I ended up on her doorstep feeling really crummy. I was having a flare-up of a very painful condition that no one has been able to explain. Perhaps once or twice a year, I get a terrible pain in my bladder, like I have a urinary tract infection, except that when I use the bathroom, the pain radiates from my bladder, right up through the center of my body, down my arms, all the way to my hands and the tips of my fingers. I yell and cry until it passes. I’ve been checked many times for UTIs, and it’s not a UTI. No one seems to know what it is. (If anyone reading this knows what it is, please tell me!)

I told my OT what was happening, and she said, “What would you like to try? The big heavy blanket? The Thumper?” I went for the big heavy blanket and immediately felt comforted. As I was lying on the floor, enjoying my little piece of heaven, the OT asked me a number of questions about my sensory diet. For some reason, I was able to rattle off a list, even though I hadn’t made one on paper yet. Here’s my sensory diet, so far:

1. Using a 15-lb weighted blanket when I get home from work and when I go to sleep at night.
2. Using a 4-lb or an 8-lb weighted vest when I need to ground.
3. Holding onto a velvet skirt and scarf, touching them with my hands and rubbing them on my face.
4. Bicycling on a stationary stand.
5. Playing with a gyroscope on a wire track, watching it spin around and around.
6. Playing with a magic wand that has spinning lights.
7. Watching my spoon mobile spin around and around.
8. Working on art projects–bending wire, putting things together and taking them apart, and watching them spin and sparkle in the light.

When I started feeling better, I got out from under the blanket and we worked on some exercises for me to do at home. These included therapeutic brushing, drawing an infinity sign, and lying on the floor watching a spinning mobile.

Therapeutic Brushing
My OT told me to try therapeutic brushing, twice a day, on my arms and legs. The purpose of the brushing was to “wake up” the nerves in my extremities, with the aim of helping to reduce my tactile defensiveness. She warned me that if I have any trauma issues, the therapeutic brushing might start unlocking memories in my body and generally erode my defenses. The brushing can also be very over-stimulating, even though it is supposed to be calming.

At first, the brushing at home seemed to go well, but very quickly, I began to resist it. I felt myself getting more and more anxious and over-stimulated as the week went on, and I began to feel somewhat raw and undefended. I came to the conclusion that after many years of trauma recovery work, I’ve stripped off as many defensive layers as I need to. The remaining ones are necessary and I’m not willing to mess with them. So, I stopped the brushing midway through the week.

Drawing an Infinity Sign
We worked on having me draw an infinity sign, tracking the pen with my eyes without moving my head. I found this exercise a bit frustrating. The purpose was to help me train my eyes to work independently of the rest of my body, with the aim of diminishing the dizziness from my gravitational insecurity.

I noticed that I when I used my left hand (my dominant hand) to draw, I tended to stare at the dot at the center of the sign and track the rest with my peripheral vision. When I consciously tried to track, my eyes seemed to go faster than my hand. When I switched to my right hand, however, I was able to synchronize my eyes with my hand, perhaps because I had to concentrate harder when I used my non-dominant hand. It’s also possible that my left brain is my visual center. I am the left-handed daughter of a left-handed mother, and that can mean that the typical functions of each hemisphere are switched. In any case, drawing with my right hand seemed to click.

Watching a Spinning Mobile
I was supposed to lie on the floor in my loft, watching my mobile spin and tracking the circle without moving my head. I tried it. Once. I immediately got nauseous and dizzy. I didn’t try it again from the floor. I can watch it spin nicely at eye level, so I’m sticking with that.

© 2009 by Rachel Cohen-Rottenberg

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