Sunday, January 9, 2011

Distress Tolerance A.T. Directive

I just started using a new A.T. directive that can tack onto groups about self care, distress tolerance and/or grounding skills. It's based on something someone from my supervision class last year was doing with nurses in hospice work. (Thank you Jackie, if you happen upon this.)

Often in these groups the how-to of using the five senses to stay present seems to come up. I talk about how engagement in the moment (and distraction from a stressor) is easiest if it isn't forced and is something enjoyable. Then we go over the five senses and name things that people find a pleasure to see, smell, taste, hear and touch. The list often includes things like a fire, fresh cut grass, fresh fruit, laughter and hugs, for example... the group comes up with their own, whatever it may be for each individual.

A common response to this list is, "Yeah, but who can think of that when feeling triggered?" And the next logical answers are, in my opinion: 1. It takes regular practice when one is not being triggered and 2. Start small. What is the absolutely minimum most simple thing we can do?

Enter sense of smell and small pocket-sized item: the little smelly bag thing... registered technical term.

I wanted to purchase bags to do this, but I could only find clear mesh bags that people use as party favors at weddings in the local Michael's and Joann's where I spend most of my time and money.  I wanted people to decorate their own, so that fabric didn't work. However, you can find muslin bags that would be ideal online here. I just bought some white cotton scrap for a dollar and made a bunch myself, which is simple, but dull work.

Supplies You'll Need

1. Fabric and string (or the aforementioned muslin/cotton sacks).
2. Stamps (optional)
3. Fabric Markers
4. Smelly stuff like dried flowers or potpourri
5. Safety pins or paperclips
(This was all from Joann Fabric dollar bins, by the way. No great expense.)

I thought it would be great to let everyone choose and stamp their own bags, but because I have a massive stamp collection and don't want to carry it around, I decided to prestamp. Also, since I made the bags myself and found it fun like factory work, I knew if someone smeared a stamp or something and wanted another bag, a little piece of me deep inside would be a teensy bit irritated and that's a good emotion to avoid when leading groups for the most part.

Some Prepped Bags (with dollar bin stampage.)

I left some blank, stamped some with an image or word on one side and stamped some with an image on one side and a word or phrase on the other, so there are several options.

I also cut a bunch of the string to the right size and burned the ends to keep it from fraying. 

I think it is valuable to finish a directive with A.T. materials and supplies oneself if at all possible before experimenting with others, so one knows if additional technical directions are needed or if there are any potential pitfalls.

That being said, here are directions that work.

1. Select a bag
2. Place folded piece of paper flat inside bag to keep marker from bleeding through to other side.
3. Use fabric markers to color and decorate. Keep in mind markers that touch another area wet with marker will bleed together. That can be a tad cool, but if you're looking for a sharp line, allow one color to dry before touching it with another marker.
4. Select string and use safety pin or paperclip to thread through drawstring opening (which you need to leave if you make these yourself. You don't need this step at all if you bought the bags with strings and you'll probably need to thread bags yourself with small breakable strands if safety is an issue with your population.)
5. Place a spoonful of perfumed stench, a.k.a. potpourri, in bag.
6. Tie up bag. Place in pocket and give good squeeze and whiff when practicing grounding skill.

This is a completed bag. The other side of this one says "It gets better."

No comments:

Post a Comment