OCD Support and Recovery Group

Here is the poster for the OCD Support and Recovery Group

The group is run alternate mondays 6:30-8:30pm at the Mental Health Independent Support Team (MhIST) in Bolton!

 

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Creative Writing as a Therapeutic Intervention: A Reflection on a Training Course

I attended a training course at the University of Huddersfield yesterday, actually called “Yoga for Creativity”. As much as the course was demonstrating how yoga techniques can enhance well-being, the facilitator asked us to explore how to use creative and meditative writing as a means of therapeutic intervention. The basis of this reflection is how creative and meditative writing can be applied in  mental health settings as a therapeutic intervention, and a further reflection will be written exploring Yoga as a therapeutic intervention.

The first exercise which the facilitator asked the group to engage in really excited me as I started to think that this is an intervention that could be utilised within my practice. The activity was taken from Goldberg (1986) where writing is used as a ‘timed exercise’. The facilitator asked us to:

  1. Write continuously for 10 minutes 
  2. To keep our hands moving with no pauses in writing
  3. No crossing out
  4. Forget the rules of spelling, punctuation and grammar
  5. Lose control, don’t think and forget logic
  6. Go for the jugular (don’t be afraid to dive right into writing that exposes our feelings or makes us feel naked)

After the allocated 10 minutes we could read what we had written and discuss with our neighbours the content (if we so wished). Surprisingly, the activity didn’t end there and the facilitator asked us to highlight up to 8 sentences in our creative writings. These sentences had to ‘jump out’ at us or offer meaning. After choosing our 8 sentences, we were asked to then make a poem out of the sentences in any order. This was brilliant. I began to think about how I could potentially use this as a therapeutic intervention related to mental health, and namely within my OCD Support and Recovery group.

As I was carrying out the exercise, I felt a sense of exposure, but this wasn’t anxiety provoking. It led to more of a curiosity as to what would come out from my 10 minutes writing without pausing. I guess it’s a lot like Freud’s  ‘free association’ but with a little bit of a twist. I like that idea a lot!

I think that if this intervention was used within my group, it has the potential to get a lot of ‘thoughts’ out on paper. For some this could be more anxiety provoking than others, dependent on the nature of OCD and the content of intrusive thoughts and obsessions. This is something that will have to be further explored through talking this activity through with members of the group to hear their perspectives and possible anxieties.

Possible Intervention

Follow the guidelines for intervention above but:

  1. Ask group members to write for 10 minutes continuously on the theme of OCD
  2. Highlight up to 15 positive words or sentences
  3. Adapt those 15 words into a creative poem related to their OCD.

Action Plan

  • I intend to research the evidence base for creative writing as a therapeutic intervention further. I have bought a book titled “Writing Well: Creative Writing and Mental Health” by Deborah Philips, Liz Linington and Debra Penman and also have a couple of chapters photocopied from “Ordinary Magic: Everyday Life as Spiritual Path” by John Wellwood from the training course attended. This will be read and studied further.
  • Speak to group members about their perspectives on using creative writing as a therapeutic activity to inform part  of their Recovery Action Plan.
  • Conduct the adapted activity on myself and see if it works.
  • Reflect further once I have used this activity on myself, and within a therapeutic environment.

References

Goldberg, N. (1986) Writing Down the Bones. Boston: Shambhala

Philips, D. Linington, L. and Penman, D. (1999) Writing Well: Creative Writing and Mental Health. London: Jessica Kingsley Publishers

Wellwood, J. (1992) Ordinary Magic: Everyday Life as Spiritual Path. London: Shambhala

Meditation and Breathing Exercises: A Quick Reflection

I have been attending a Mindfulness Meditation group for the last 8 weeks and during my time as an attendee I have experienced a variety of mediations, breathing exercises, learned some Mudra’s and listened to some interesting excepts from books such as ‘The Power of Now’ by Eckhart Tolle.

Prior to attending this group I had little experience of meditation and breathing exercises. I had used ‘Progressive Relaxation’ with clients who experienced anxiety disorders, but this was the length and breadth of my knowledge of breathing exercises and anxiety management. Today though, I was introduced to a very interesting breathing exercise by a very experienced Yoga and breathing exercises teacher. The exercise encourages you to exercise your entire lungs, and in rather an interesting way by directing your thumbs in different directions (I will write a further blog with pictures to illustrate this with instructions on how to use it). After completing this exercise I was left with a sense of contentment, energised and totally relaxed.

I feel that this particular exercise is easy to do, learn and easy to apply to practice. It has broadened my range of skills in anxiety management, and leaves me with a stronger sense of confidence in applying breathing exercises for my OCD Support and Recovery group.

I believe that this breathing exercise benefits the client by promoting a sense of wellbeing, but it also exercises the entire lungs and aids in increasing lung capacity. This not only would be a useful intervention to utilise in mental health but also possibly in pulmonary rehabilitation with clients with respiratory disorders such as COPD or asthma. Infact, one group member commented how 60 years ago, as a child she had asthma and recalled a similar intervention in hospital to help manage her asthma before inhalers became the norm.

Action Plan

  • I am going to do a write up about this interesting breathing exercise, and will include pictures to show how to position your thumbs.
  • Use this breathing exercise with my clients who may experience anxiety to work on increasing their wellbeing and providing them with an interesting tool to manage their own anxieties to enable optimal occupational participation.
  • Investigate further breathing techniques to broaden my range of skills for anxiety management and document these on my blog.
  • Make enquiries about local Yoga classes to attend to learn techniques to promote my own personal wellbeing and to integrate into my own practice with clients too.

Reflection: Personality Disorders

Following a discussion with a dear friend of mine who has a diagnosis of Borderline Personality Disorder (BPD), I realised that my knowledge base regarding Personality Disorder (PD) was not as up to scratch as I thought it should be. I discussed the topic of BPD but felt that as an occupational therapist who works with people with mental health problems, I should understand this more so that I am equipped with the skills to work with this client group and understand the difficulties they experience and how it affects their occupational performance in their every day lives.

I have had previous discussions with other mental health professionals regarding PD but have never really gone away to think about my lack of knowledge, but this I feel is not acceptable as a health care professional. That said, I feel now is the time where I should understand this client group more so, so that I can offer a service that caters not only for people purely with Obsessive Compulsive Disorder (OCD), as I understand that many people who live with OCD will also experience a PD too.

I will now research PD in general and write a piece dedicated to my updated knowledge of this client group. The aim of this reflection is to increase my scope of practice and to offer a service that is truly client centred, professional and inclusive of all who experience mental health problems.

Action Plan

  • Research the spectrum of PDs provide an evidence based blog post, relating it to how PD can affect occupational performance.
  • Apply this knowledge to practice.

Reflection on Discussion: Child and Adolescent OCD

Reflection

Today I had an interesting conversation with a fellow OT on twitter, I was asked for advice on what best practice would be on working with children and young teens with OCD, this has got me thinking of how occupational therapists can assist in the assessment, treatment and management of OCD in children and young people.

I think this is an area of practice that needs to be explored, and with OCD being cited as the 10th most disabling condition outlined by the World Health Organisation, this is a huge area of practice that has been very unexplored, especially within child and adolescent mental health.

Where to go from here? 

I think it is my duty now to research how occupational therapists can offer assessment, treatment and offer support to children and young people who experience OCD. I will look for articles to inform my practice and pass these on to relevant occupational therapists who would benefit from this information.

Action Plan

  • Research the evidence base
  • Liaise with other mental health professionals
  • Document my findings in another blog post and make this accessible to other occupational therapists