Wintering

Over winter break I listened to a podcast called "How 'Wintering' Replenishes" from the On Being podcast, and just loved  it. A couple weeks later, I began my first occupational therapy fieldwork rotation in a hospital working with kids/adolescents who are admitted for severe mental illnesses. A few days ago I decided to re-listen to this podcast because I felt I could understand this fieldwork in a whole different way. I wrote the following blog post to connect "wintering" (quotes from the podcast are in italics) to an inpatient mental health setting. 

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I walk down a long, cold, windowless hallway with white walls. To my left is a handwritten poster that reads life is tough, but you are tougher. I reach in the pocket of my grey scrubs until my fingers find a cluster of metal keys. I let each fall through my fingers, running my fingertip gently across the cold ridges of the last key before it falls back down into my pocket. 

"Have you ever been to the sensory room before?" I ask, turning back to look at my patient, a 15 year old girl who's eyes are cast down to the floor. Without looking up, she shakes her head no. 

“There are gaps in the mesh of the everyday world, and sometimes they open you, and you fall through them into somewhere else. And somewhere else... runs at a different pace to the here and now, where everyone else carries on.”

I unlock the sensory room door and lead us into a dark room that has a variety of cozy seating options - a layered lycra hammock swing hanging from the ceiling, a beanbag, and a rocking chair. Mounted on one wall is a vast black velvet board decorated in tiny golden specks of light.  On the other wall is a projection from a light fixture that looks like the northern lights - a warm wintery swirl of cool blues, gentle greens, and deep purples. I invite the patient to sit anywhere they feel comfortable, and she slips easily into the layered swing, letting the layers catch her and hold her in mid-air. 

These teens are often coming to the hospital because of poor coping skills, low self esteem, and safety concerns about their overall well-being. They are in desperate need of a form of hibernation - a time to stop, slow down and focus on coping skills that are crucial to their survival. This care gives them the ability to fall through the gaps into that "somewhere else" - a place to focus on healing and piecing back together their daily routines and self worth. 

Often, when we lead patients into the sensory room, they are guarded, withdrawn and quiet. We provide them with sensory tools to touch and hold while we chat with them. Many patients often pick the fiber-optic light - a small cylinder that has long strands of illuminated fibers shooting out of it.  The patients run their fingers through the strands, watching the specks of light change from red to pink to purple. As we ask them questions about their support systems, hobbies, sensitivities to sound, touch or taste, I watch them begin to relax and become more open and willing - almost like watching someone exhale in slow motion. 

"Wintering is a metaphor for those phases in our life when we feel frozen out or unable to make the next step, and that that can come at any time, in any season, in any weather... I don’t think we want summer that often. I think summer can be a bit too much, in the way that winter can be a bit too much, those extreme highs. You can’t abide with them for too long. But what we can abide with is a sense of balance and self-regulation. And I think that’s often what we’re seeking, on our way out of a winter. How can I come back into an equilibrium, rather than keep bouncing between extremes?"

During a group session, we draw a diagram to show when our body's nervous system is at equilibrium, and how triggers can send it into either an elevated or depressed state - otherwise known as a stress response called fight, flight, or freeze. We talk about how important our senses are to our mental health and how they can ground us. We discuss sensory tools we can use to bring our body back to the equilibrium state. One common strategy is called a crisis coping skill - splashing cold water on your face to shock your nervous system and to bring yourself back into your body. Another is using a fidget as a way to ground you in the moment, like playing with your keys in your pocket.

“I’m beginning to think that unhappiness is one of the simple things in life: a pure, basic emotion to be respected, if not savored. I’d never dream of suggesting that we should wallow in misery or shrink from doing everything we can to alleviate it, but I do think it’s instructive. After all, unhappiness has a function: it tells us that something is going wrong."

At the end of every eval session, we ask the patient how they would like to feel when they discharge. One patient said they want to stop having so many mood swings. We talked about the importance of emotions, and then the occupational therapist gently said "sometimes feeling is coping."

It is only my third week in this fieldwork so far, but I already feel so at home in it. I feel so grateful to be here for these patients, to catch them as they fall through the gaps, to guide them through hibernation, to see the different colors of light this season brings, to feel the cold things and the warm things and all the other sensations in between. 

"Plants and animals don't fight the winter, they don't pretend it's not happening and attempt to carry on living the same lives that they lived in the summer. They prepare. They adapt. They perform extraordinary acts of metamorphosis to get them through. Winter is is a time of withdrawing from the world, maximizing scant resources, carrying out acts of brutal efficiency and vanishing from sight; but that's where the transformation occurs. Winter is not the death of the life cycle, but it's crucible."

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Listen to the Wintering podcast here.

And of course, enjoy the new playlist I made for this current season.