OTs treat clients with PTSD, TBI, autism, dementia, stroke and many other diagnoses in which the emotional system may be fragile. As an OT working with a child or adult in a therapy setting, I need to have tools available to help keep my client emotionally organized and well-modulated so that the interventions are better accepted.
From the sensory integration viewpoint, we can (to keep it simple) speak of three aspects of emotional skill: registration, seeking/aversion behaviors, and modulation.
- Registration of emotions refers to whether or not we sense them, and to what degree we sense them.
- If we excessively seek or excessively avoid emotional experiences then we have seeking or aversive behaviors.
- The degree to which we are affected by emotions and react to them are aspects of modulation.
We speak of "palpable emotions" - you walk into a room and you can feel the excitement, fear, sadness or joy of a person or a group. I think of this as "sensing emotion", in the same way that we "sense" taste or vision. I believe that we all are able to sense emotion to some degree. There are three categories of emotional sensitivity: typically sensitive, hypo-sensitive, and hypersensitive. A person with hypo-sensitive emotions will have difficulty registering emotional content and may not understand why others are affected in certain emotional situations. A person with hypersensitive emotions senses emotional content more intensely than others. He or she may even be bombarded by it.
Some of us seek positive or negative emotional experiences, or both. We may seek emotions because we are hypo-sensitive and our brains are trying to get the sensation. We may seek emotional experiences because we are hyper-sensitive and enjoy the sensation and want more. We may avoid emotional experiences for a variety or reasons. We may be hyper-sensitive and easily overwhelmed by emotional experiences. We may be hypo-sensitive and find the experience boring or confusing.
Handling Emotions (Modulation)
We can split emotional modulation into two aspects: receptive and expressive. We need to be able to modulate both our reception of emotions and our reactions to emotional experience. A well-modulated person moves in and out of sensory experience with ease. An emotionally well-modulated individual moves in and out of emotional experiences with ease.
The topic of emotions is incredibly complex. Briefly, from the eyes of an OT, here are some simple examples of poor receptive emotional modulation: inability to understand cultural differences, inability to see someone else's plight, inability to process complex emotional situations. At the other extreme are people who "feel too deeply" and who perhaps read too much into a situation they are witnessing.
Some examples of poor modulation of expressive emotions include tantrums and rages, social phobia, and heavy emoting. At the other extreme is the lack of expression of emotion.
The OT Viewpoint
As a sensory-based OT, I am concerned with the physiological aspect of sensing and reacting to emotions. My interventions incorporate recorded music, social situations, excitement level in the environment, sensory input and special tools such as sound therapy to shape the mood and induce the appropriate reaction. I work in the same village as the behaviorist or cognitive therapist, but do not offer the same practices nor do I necessarily look for the same results.