Tanya is a lady whose medication can impact her alertness levels; sometimes she can be very awake and on other occasions her fatigue levels mean she sleeps in the day. She is very nervous of touch. She can also be prone to self-harm and throws things when she becomes more anxious. On this occasion Tanya was asleep upon our arrival. We re-introduced ourselves and spoke to Tanya as though she were awake, allowing for the possibility that she could still hear us when in a lighter sleep. As we sang our session-opening song, Tanya stirred a little in her sleep and we felt it was likely that she was aware of our arrival.
We value research that has shown there is worth in what we call ‘Sleepy sessions’:
“When we consider the concept of consciousness, it first appears that conscious awareness of stimuli is lacking, but in actuality, some sensory, attentional, and mnemonic processes are still (partially) intact.” (Psyche, Volume 16, issue 2 – Processing During Sleep)
We used some singing, as she enjoys all music, and talked to her about her positive qualities and things we were noticing about her position and movements. As Tanya appeared so relaxed we very gently and cautiously began to explore holding her hand, seeing if this was something he was content to agree to at this time. At all times we gave very detailed but simple verbal description of what we would do and how.
I began with mild hand stroking and then as I noticed Tanya’s right toes twitching I moved to rubbing her foot. Alongside this my colleague was observing Tanya’s eyes moving under her eyelids and when Tanya moved her hand at her face my colleague followed this movement and this progressed into a scalp massage. At all times we monitored Tanya’s subtle movements for signs of response and she remained relaxed, occasionally stirring and giving small movements or delicate sighs. Tanya chose to bring her other foot out from under the quilt and put it next to my hand therefore I was able to massage both her feet – something that would have likely been difficult for Tanya to accept when wide-awake and even harder to enjoy.
Towards the end, continuing our constant narrative, I told Tanya I was going to remove my hands ready to sing the ‘Goodbye’ song and my colleague did the same telling her he would move his hands from her head for ‘goodbye’. We began to sing and Tanya opened her eyes and looked directly at my colleague, in line with her head, and then turned to look at me, still by her feet, before closing her eyes.
We felt this was Tanya’s own way of acknowledging our presence and we were pleased that she was still so relaxed in our company.
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