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How to act with arousal in mind

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DBI World Conference 2019
Communications stream: Concurrent session 7F
Presenter: Lone Rømer Jensen
Topic: How to act with arousal in mind

Published in: Healthcare
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How to act with arousal in mind

  1. 1. LONE RØMER JENSEN CENTRE FOR DEAFBLINDNESS AND HEARING LOSS, DENMARK How to act with arousal in mind
  2. 2. ABOUT US Centre for Deafblindness and Hearing Loss (CDH), Aalborg, Denmark Brochure available; https://bit.ly/2YU4kUP
  3. 3. A NEUROPSYCOLOGICAL PROJECT 4 adults with congenital deafblindness and multiple impairments Self-stimulating behaviour prior to the project
  4. 4. RESEARCH QUESTION How does the arousal framework help us to analyze, describe and act accordingly, in our daily work of ensuring an appropriate level of attention and readiness for interaction and communication?
  5. 5. WHAT IS AROUSAL? Regulating internal energy The importance of interactions Visible in unconscious bodily reactions
  6. 6. THEORETICAL METHOD Neuroaffective Developmental Psychology by Susan Hart The autonomic compass; a model of energy management and body sensations
  7. 7. PleasureDispleasure Activity / Sympathetic Passivity / Parasympathetic Hyperactivity Disarming smile Brief alarm response Curiosity Vitality Engagement Low energy Passivity Brief freeze Relaxation Rest Urge to cuddle Exaltation Mania Extreme daydreaming Narcolepsy Fight Flight Helplessness Sustained freeze Axis of hedonic tone Axis of arousal regulation Reference: Bentzen & Hart, 2015, p.47
  8. 8. INDICATOR POINTS IN THE AUTONOMIC COMPASS PleasureDispleasure Passivity / Parasympathetic Activity / Sympathetic
  9. 9. SIMON Case presentation Prior to the project; general state and behaviour
  10. 10. Activity / Sympathetic Passivity / Parasympathetic Displeasure Pleasure INDICATOR POINTS FOR SIMON
  11. 11. AROUSAL REGULATING ACTIVITIES Creating arousal regulating activities Activities for Simon: Clapping/padding activity Sensory activity board
  12. 12. PICTURES OF SIMONS SECOND ACTIVITY Left: Homemade sensory board, made from a kitchen cutting board with colorful items. Right: Placed on an tablet holder on a table.
  13. 13. RESULT AND CONCLUSION FROM THE PROJECT Based on observations, we found that sensory stimulating activities planned with arousal in mind: • seem to have minimized the need for self- stimulating behavior and • helped to improve attention and readiness for interaction and communication. •Understanding communicative expressions.
  14. 14. REFLECTIONS • Which activities do you see useful, to influence high arousal or low arousal? • Share your experiences.
  15. 15. PleasureDispleasure Activity / Sympathetic Passivity / Parasympathetic Hyperactivity Disarming smile Brief alarm response Curiosity Vitality Engagement Low energy Passivity Brief freeze Relaxation Rest Urge to cuddle Exaltation Mania Extreme daydreaming Narcolepsy Fight Flight Helplessness Sustained freeze Axis of hedonic tone Axis of arousal regulation Reference: Bentzen & Hart, 2015, p.47
  16. 16. THANKS TO My fellow colleagues in the residential home for creating this project, developing the knowledge and experience. Tina Bendixen and especially Tanja Møller Christiansen for being my “partner in crime” – developing the knowledge and keeping the arousal-project alive and spreading the word around the world 
  17. 17. SUPPLEMENTARY MATERIAL
  18. 18. ADDITIONAL ACTIVITIES Picture: Handy-sling (walking aid for a personal lift in the ceiling) and moving disco lights, where the resident with a visual impairment walked in a dark room, searching for the colorful light. In combination with the physical stimulation, this activity helped to awaken her body and mind, and thereby heightened her arousal level to the quadrant of active/pleasure from the quadrants passive or active/displeasure.
  19. 19. ADDITIONAL ACTIVITIES Picture: Sensory stimulating massage ball. This ball was used in an activity where an individual with high arousal (quadrant active/displeasure) needed help to lower his arousal. This activity was altered to massage where hands was used, instead of this ball. Over time, this had a positive effect, where we could help him regulate his arousal to the quadrant of passive/pleasure.
  20. 20. ADDITIONAL ACTIVITIES Picture: Sing-a-long book (song: Wheels on the bus go round and round). Activity where we combined singing with physical gestures and signs. By doing this half an hour before dinnertime we could help a female resident to regulate her arousal level from very low (quadrant passive/pleasure) to a more balanced level (quadrant active/pleasure), in order for her to stay awake during mealtime. By doing this activity every day for two to three years, she has slowly altered her internal energy level – basic level of arousal - from passive to active, where she is more awake during the day.
  21. 21. REFERENCES Literature in English about the neuroaffective approach; Bentzen, M. 2018. The Neuroaffective Picture Book. North Atlantic Books. Bentzen, M., Hart, S. 2015. Through windows of opportunity – a neuroaffective approach to child psychotherapy”. Karnac Books Ltd. Hart, S. 2018. Brain, Attachment and Personality: An Introduction to Neuroaffective Development. Taylor & Francis Ltd.
  22. 22. lrj@rn.dk Centre for Deafblindness and Hearing Loss, Aalborg The North Denmark Region LONE RØMER JENSEN Pedagogue

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