By Anne Laney, Practice Manager
I’m sure I’m not the only one spending vast chunks of time analysing exactly what I am feeling at the moment. What is it about our current situation that frustrates and angers me so much? It is a deep, visceral experience that I feel sure must be commonplace. I also feel sure that it is an experience many of the people who join in Us in a Bus sessions might feel often. I’m thinking about loss of, or lack of control over our lives. For me, the experience of suddenly being told what to do, being made to obey the rules, is simultaneously both an incredulous thought and an unacceptable one. It brings out rebellious non-conformity in me and is based firmly both in my upbringing to ‘question and challenge’ and my not being able to understand how the decisions being made have been reached. It is this concept of ‘not understanding’ that is so relevant to this exploration of control.
For many of the people who participate in Us in a Bus sessions, every event in their life is potentially unexpected and creating uncertainty and they may not understand what is happening. They feel their bodies chemical responses to the uncertainty in the same way they may feel hunger (using their interoceptive sensory systems), but do not necessarily know what it means. Unlike me, they possibly or even probably are not able to process in any meaningful way the complexities of the processes taking place. They return to the things they do know and can control. The things that often appear peculiar or unusual to onlookers. The sensory stimulating or muting ticks and twiddles those of us who know people well are familiar with. They are using these things to maintain what is known as homeostasis, the state in which the human body operates most efficiently.
Many devise complex and complicated systems for regulating their world so they remain in homeostasis and they are likely to be doing this automatically, without knowing why. They have ways to ensure their sensory and hormonal systems are balanced and they are in a place of neutral arousal. This homeostasis is necessary for people to function socially and intellectually within whatever capacity they have and when out of kilter, results in them finding ways to regain the balance. Situations that upset the balance to homeostasis create uncertainty. Uncertainty is the most unsettling condition for all humans, as it triggers many biological and neurological responses. Our body and brain then fight to make sense of this and 1 refer to past experiences on which we build our life understanding, and process current sensory information simultaneously, making sense of how these things interact and directing us back to balance. Even if the uncertainty being experienced is potentially positive, for instance an upgrade to first class train travel or an unexpectedly larger chocolate bar, it is recognised as different and the drive towards equilibrium and homeostasis (known as allostasis) and away from uncertainty is initiated.(This is explored in all its complex detail in the book referenced beneath) 2. Many people with Profound and Multiple Learning Disabilities and complex needs regulate themselves by engaging in self exploratory or sensory activities, frequently things that engross them so much they appear self-absorbed, until their equilibrium is restored.
When analysing what triggers the moments when homeostasis is disrupted, it seems that unexpected, unplanned events are often contributory. Moments in fact when control is removed. The predictability and reliability of life is taken away and the experience imposed is a strange mix of anger, irritation, reticence, incredulity, fear and exhaustion. These are exactly my emotions now and cause me to resort to my own equilibrium restoring techniques, usually involving having a rant, a glass of wine or a cry. I also, and this is important, process my experience intellectually. I have the capacity to work out what’s going on. Why I feel grumpy. To negotiate with myself. To remember that I know about homeostasis and that what I’m feeling and doing is connected to my returning to my level place. Consider the fact that some people we know are possibly, constantly, not in control of many aspects of their lives. I say ‘not in’ control rather than ‘out of’ control intentionally as it covers the experience of many people with profound and complex communication and sensory needs of not having enough established, shared language with those around them to enable active, reliable choices.
The thing that has struck me, as I consider all of this, is how unsettling life must be and, how obvious it is why people invest sometimes vast levels of energy and time in finding ways to regain that homeostasis. And, how skilful to be able to create one’s own safe space. Certainly I am nowhere near as effective at modifying my world into effective balance. The people we see have often spent their whole lives exploring the best options for themselves. I have not.
What we aim to do when we visit the people we see is find ways to establish mutual understanding based on their language, not ours, and then to go on to explore how people might like to engage socially. Recognising that the things people are already engaging in are designed to maintain their internal balance, and doing them with them is fundamental to Intensive Interaction. Intensive Interaction does therefore, effectively support homeostasis. At its heart, it recognises the importance of what people are doing and that these things can be the key to connecting with them.
Understanding the maintenance of homeostasis and its relevance to human well-being, and linking it to the practicalities of Intensive Interaction, adds another layer of evidence to why Intensive Interaction is so effective. Of course it is. By reinforcing someone’s own regulatory skills by doing it with them so they notice we’re doing it with them, is adding another layer of calm to their world; like supplying a psychological and often physical comforter. We’re giving them the message we understand they might feel out of control and that we see the value in their methods of regaining it. We want to learn from them, not change them.
This all swirls around my head, and the intransigent nature of these emotions occurs to me. They come and go, layer up some days, thin out on others. As with the people Us in a Bus are involved with, perhaps the key for me is to not try to understand in any way, other than a sensory based one. Perhaps, in these uncertain times, self-imposed ignorance of fact and focus on homeostasis, might be, if not bliss, then at least relief.
- Dr Jamie Galpin “It’s what’s on the inside that counts: Getting in to interoception” 2020 ( From presentation Sensory Spectacle Interoception Conference March 12th 2020
- The Interoceptive Mind: From Homeostasis to awareness. Edited Manos Tsakiris and Helena De Preester. (chapter 15)