Creating Rapport and Therapeutic Benefit through Movement, Music, and Meditation

Leah Smithblog, meditation, movement, music, rapport0 Comments

Presented by: Leah Smith, Judaic Program Supervisor, Certified Snoezelen Trainer, Reiki Master

Tamir Foundation Ottawa, Ontario Canada

Often people with disabilities find it challenging to make meaningful connections to the environment around them and to make sense of what they experience within; this can provoke feelings of stress, anxiety, fear, confusion and isolation. The lack of connection for an individual can lead to sensory imbalances, which can result in aggressive outbursts, self injurious behaviour and depression, particularly for people that do not have language skills to communicate their needs and desires. This essay demonstrates that people with developmental disabilities can attain great therapeutic benefit by participating in movement, music and meditation exercises, thereby assisting individuals to make essential connections with the external environment as well as their inner thoughts, feelings, and body sensations.

Presented in this essay are a variety of simple techniques that can enhance what is already being done to facilitate sensory integration for adults and children with disabilities. These techniques are very accessible and can be practiced in or outside of a Snoezelen Multisensory Environment, to be shared with one person at a time or with a group. However, in order to provide these therapeutic benefits, it is necessary to first examine how sensory imbalances occur, and, how to create rapport with your clients.

Sensory Imbalances

Important information about the physical world is obtained through the senses. Sensory imbalances can result from over stimulation, under stimulation, or simply the wrong kind of stimulation. It is through a process of trusting the information from the senses that a person knows when they are safe with someone or something. To facilitate sensory integration, it is important to discover the sensory preferences of an individual. Using keen observation you can notice what a person is attracted to and identify actions, activities or items that make the person feel safe. If something is not working, then try another technique. Be patient and experiment; once the sensory preferences of the individual are established, choose the movement, music and meditation techniques that will best suit the individual.

Techniques for creating rapport

In order to gain maximum benefit from movement, music and meditation it is necessary to first establish rapport with the individual or group. Rapport is essentially about making connections that are meaningful to the individual; this can pave the way for assisting people with developmental disabilities to come back to their senses and be fully present in the moment. Below are a variety of techniques to assist practitioners in creating rapport with the participants they serve.

Silence

Some individuals may prefer to simply be in the silence together; it is through non action that you will be able to find a way into their world. It is useful not to focus on outcomes – allow therapeutic benefit without focusing on therapeutic content. Being open minded and flexible can lead you to the discovering what will work best for the individual.

Voice

Be aware of the tone, pitch, volume, and speed of speech. Slow, low tones are soothing and can easily put a person at ease.

Eye Contact

Direct eye contact can draw a person in or scare them away; find the right balance, such as a soft gaze rather than a fixed one. Talking about things the person is looking at may also help to create rapport and open communication.

Body Language

Maintain a non-assuming, open posture; be welcoming in a gentle non-forceful way. Sometimes unpredictable movements can catch a person off guard in a good way; be open and friendly yet non invasive. Use simple expressions and movements and provide a lot of space and room to breathe.

Matching and mirroring

When used with respect, matching and mirroring can be a very effective technique for creating rapport. In its simplest form matching and mirroring is about copying the body language, actions, hand gestures, sounds, and speech patterns of an individual which creates a connection with that person. For best results do this in a subtle way so that it happens at an unconscious level.

Movement

Movement is essential to good health and well being. It can renew the vital life energy in the body and stimulate the neurotransmitters in the brain that send messages to the various systems in the body responsible for respiration, digestion, circulation, immune function and fine and gross motor control. Further, movement stimulates brain chemistry and facilitates healthy functioning, and encourages the body to perform as a whole unit rather than individual parts. Other benefits include an overall decrease in stress. It is important that the physical activity be enjoyable and tailored to each individual’s needs and abilities, thereby fostering success and increases in self-esteem.
It is useful to do a variety of movements from different vantage points; standing movements will encourage balance and posture, sitting down movements allows the freedom of not having to hold the body upright, and lying down supports the entire body so that all of the joints can be totally mobilized.

Body Balls are excellent props for movement with individuals of all levels of ability and disability. These versatile lightweight balls come in a variety of colors and sizes and can be used while standing up, sitting or laying down. Activities can include playing catch, rolling, hugging, slapping, or kicking the ball, which can create a lot of excitement for individuals that are under stimulated. Another simple activity is sitting on the ball and jumping or bouncing up and down. All of these approaches help to get the body moving, and increase circulation and cardiovascular health.

Some individuals have set repetitive patterns for walking, pacing, rocking, or flapping; it can be very beneficial to go with the flow of their movement. Sometimes these movements are a persons coping strategy for stress; the rhythmic nature of the movements is soothing and gives an individual a focal point for moving energy through their body. Going with the flow of movement and then encouraging the movement to exaggerate beyond the normal pattern can break the cycle and help elicit a relaxation response.

Putting music on and encouraging the individual or group to move around the room is a very simple approach that everyone can follow. Encourage participants to follow their bodies, instruct them to move around the room the way their bodies like to move; this approach can be very enlivening for everyone. People with limited mobility can derive great enjoyment and therapeutic benefit from letting their body lead the way.

Playing games is also a useful movement technique. For example, play charades by moving around the room imitating animals and have the participants follow along. ‘Simon Says’ is another effective way to get the group to follow your lead. Practitioners may give simple directions such as reach for the sky, curl up like a ball, stand at attention like a guard, hold your arms out like an airplane, reach over and try to pick something up off the ground, or pretend to sit down on a chair while standing.

Matching and mirroring can also be used as a movement technique – copy the rhythms of the person while they rock, pace, shake, swing, jump, etc. Once you have created rapport with the individual, try doing a variety of simple slow movements that promote relaxation and body awareness and encourage the individual to follow you. Overall, it is useful to change the pace at which people move from slow motion to exaggerated movements, or move quickly, speeding up the heart rate and providing good aerobic exercise. Movement in one part of the body at a time is beneficial as well as symmetrical movement i.e. shaking both wrists, bending both knees, and shaking the whole body at the same time.

More able individuals can benefit from a structured approach. Demonstrate simple movements or postures and allow individuals to stay in the positions for a few moments or longer if they are comfortable. A caregiver can demonstrate simple movements that the participants can learn and do at home at their leisure.

The movement techniques presented above are both structured and free flowing. They can be modified to suit every level of ability, and can be enjoyed individually or in a group, and either in a day program setting or at home. Everyone can derive tremendous pleasure, and receive therapeutic benefit from these gentle movement exercises.

Music

Everyone has a right to enjoy sensory stimulation that is pleasing to the senses, and this will differ for each individual. Although it may appear that people with disabilities do not have very developed tastes, when it comes to sensory preferences they can be connoisseurs. Music is a basic sensory stimulation that has the power to return the listener to a natural state of wellbeing. It can soften the emotions and dissolve tension in the body and mind.

The rhythmic component of music is very organized and can assist in balancing auditory and perceptual processing, as well as fine and gross motor control. Playing music can provide multisensory stimulation that has an impact on our auditory, visual, kinesthetic and tactile senses. Using easy to play percussion instruments can assist individuals with profound disabilities find an accessible and enjoyable outlet for expressing their complex and often held in emotions. Participating in simple play-along exercises focused on a person’s ability allows an individual to succeed at something they enjoy. Regardless of a person’s level of musical understanding, everyone can use simple instruments to make music for personal pleasure. Also, joining a music play-along group can reduce the use of negative self stimulating activities and increase participation in enjoyable stimulation.

Music is a very effective means of creating rapport and encouraging self expression through matching guttural sounds, creating rhythmic sounds of speech, singing the tunes that people hum, making songs out of repetitive speech patterns. When working with pre-verbal individuals, simply matching their grunts and gurgles can lead to fostering important communication. Copy the vocal expressions of the participant and experiment with the sounds that are coming from the individual by creating a dialogue of sound.

Music can be very playful and elicit feelings of ease and satisfaction. Hearing music that is familiar from childhood can awaken a person’s sensory memory and connect an individual with the comfort and blessings of home. Nursery rhymes and simple melodies can be a strong connecting point to language and communication. Play music with or without a tape in the background, experiment with high, low and midrange tones; every tone creates a different kind of stimulation. Also, refer to the group as a band and have the participants take turns being the leader.

Clapping specific patterns and having the individual or group repeat the pattern is a good focusing and listening technique. Experimenting with the pitch, volume, and intonation of a song can have a positive impact on individuals that are hypersensitive to sounds.

Picking up percussion instruments and easily playing along with others to make music or sing can give a great sense of joy and accomplishment. Participating in these activities can also establish important building blocks to relationships and sense of community. With a ‘sing and play along’ group you can begin to develop listening skills; practice different rhythms choosing songs that are slow (three quarter time like a waltz) and up beat songs with a more lively pace. You can switch from playing at a medium volume, increase the volume, or switching again to play as quietly as possible. Alternatively, you can experiment with the speed by starting slowly, increasing the speed and then slowing down. All of these exercises will begin to teach some of the basic fundamental components of music and help to build listening skills, cooperation between the group, self esteem and great satisfaction.

Creating a choir for individuals that love to sing can be very rewarding and help to develop focus, teamwork, self esteem, discipline, and a sense of belonging. Performing at a variety of venues in your community is an effective way to raise awareness about the abilities of people with disabilities.

All of the suggested approaches to experimenting with sound and music encourage playful self expression, develop listening skills, make important links with others, are simple to follow, easy to participant in, and can be adapted to match the needs of adults and children with profound, moderate and mild disabilities.

Meditation

For the purposes of this paper, meditation is defined as emptying the mind of thoughts, or concentrating the mind on just one thing in order to aid mental or spiritual development, contemplation, or relaxation. Relaxation is a process of making something less firm, rigid, or tight. States of relaxation trigger the parasympathetic nervous system which controls the body’s ability to restore wellness on all levels.

Meditation is a powerful tool that can address the complex relaxation needs of people with development disabilities; it can be used to help calm a person down when they are agitated, afraid, or angry. There is no single meditation that will work for everyone; therefore it is necessary to experiment to find one that is pleasing to the participant. Below are a variety of simple meditation techniques that can be adapted to every level of ability and disability. These techniques promote relaxation and awareness of thoughts, feelings, emotions and body sensations through breathing, focusing, gazing, guided imagery, and the use of mantras.

Simple Meditation Techniques

Use of Mantras

Repeat the same sound, word, or positive affirmation phrase over and over. For some individuals using this approach can take only a few minutes to achieve, where as others may need to stay with the process for up to 5 minutes before they experience a relaxation response.

Cleansing Breath

Meditation is a simple breathing technique that can be used to relieve acute stress. Instruct the participants to find a comfortable position either standing or sitting’ then take in a deep breath and on the exhalation let out a sound. This can be repeated as many times as needed to let go of the stress.

Matching Breath

These techniques can be used with people that are unable to follow instructions for breathing exercises. Simply start to breathe in a similar pattern to the individual you are caring for, once you have established the same breathing pattern slowly, one breath at a time, begin to expand the breathing. Once the breathing rhythm is matched, the person will automatically start to breathe more deeply. The matching technique could also be used to increase the heart rate; simply match the breathing then slowly one breath at a time increase the rate of the breathing.

Advanced Breathing

Instruct the individual to focus on their breathing encourage them to inhale and exhale slowly then add a counting component. Guide the person to inhale a breath to a count of three, then hold the breath for a count of three and exhale the breath to a count of three, or what ever length of breath is comfortable for the individual.

Focusing

Focusing is a technique that can be of great benefit when a person is highly agitated, instruct them to put their hand on their chest, to find their heart beat. This exercise will give the person something to focus their mind and become aware of their body. Often as the person concentrates their heart rate will automatically begin to slow down and return to normal.

Guided Imagery

Have the client sit comfortably in a chair or lay down (relaxation music may be used in the background); in a soothing slow voice guide the individual or group on a journey. You can create a journey that is the same for everyone or you can ask that everyone go to their favourite place and give general guidelines i.e. look at the light, the colors, are you sitting or standing, is there anyone there with you, etc. Again, experimentation and creativity are often your greatest guides. Guided meditation can also assist to relieve tension, anxiety, or pain. Start at the head or the feet and guide the person through their body; start by asking the person or group to tense an area of their body and then relax the area.

Gazing

This is another type of meditation that is easy to follow; this approach is appealing as it focuses on the individual without speaking. Gazing meditation can also be used to assist someone to move into a state of deep relaxation; simply pick an object in the room, or bring something specific into the room for this purpose, sit together and gaze at the object. You will notice that after a few minutes the gaze will soften and the breath and the body will follow this softening. Below is a case study of a spontaneous gazing meditation that had immediate and long term benefits for a Tamir participant.

Case Study

One of the gentlemen with whom I practice Snoezelen used to have a lot of tension around his eyes; he was tentative around people, hesitant and unsure of himself. He had a habit of staring at people or would stare at something that he wanted and wait for someone to comment on the object of his stare as a way of getting what he wanted.

During one of our early Snoezelen sessions I spontaneously greeted this individual in his stare. I engaged him in a gazing meditation with me. We sat across the room from one another gazing at each other for about 20 minutes. After that session the tension was gone from around his eyes and he started to use words to ask for what he wanted. His intense staring has never returned and we never did the gazing meditation again.

All of these meditation techniques encourage relaxation and can be shared with children or adults. These techniques can be especially beneficial when individuals are experiencing stress from a variety of sources, as preventative measures for wellness, and as enjoyable leisure activities.

Summary

All of the techniques and practices presented in this paper are easy to follow, and can be adapted to match the needs of people with profound, moderate and mild disabilities. Creating rapport is the critical first step while practicing any of the techniques. Rapport can be created through being respectful, greeting a person at their level of understanding and giving the individual as much control over the situation as possible. Participating in movement, music and meditation practices can provide endless hours of meaningful recreation and enjoyment. Through these activities, individuals you care for can have access to therapeutic benefits that are achievable, increase self esteem, encourage creativity, build relationships, and promote relaxation and well being on all levels. Movement, music and meditation practices can be a source of great pleasure at any time and will always bring about therapeutic benefit. The techniques presented in this paper can improve the quality of life for children and adults with developmental disabilities and encourage them to thrive in their environment and achieve greater inner peace.

Resources

Music Therapy, Remedial Music Making and Musical Activities
F W Schalkwijk

Music Therapy and People with Developmental Disabilities
By Rachel J. Peck, MT-BC

Exercise for Individuals with Developmental Disabilities
By Paul Spicer, QMRP

Beginner Workout for People with Developmental Disabilities
Ease into Fitness: IRIS Media Inc. 35 minute video

The Yoga Experience for People with Developmental Disabilities
By Mary Bryant, WARC

Matching and Mirroring
Changing Minds.org

How Rapport Can Help
By Clifford Mee

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