Alex and I came into each others' orbit through our friends neurologic education practice. I was immediately struck by the sensibility and safety of her practices, her attention to evidence based interventions, and her capacity to seemingly effortlessly weave together western medicine and wisdom traditions.
Alex is educated as an occupational therapist, with a focus on sensory integration, and also as a yoga teacher with a focus on interventions to help ease trauma. She has integrated personal and professional experiences to come up with practices that are unique- they are beyond the traditional application of our professional licenses- and yet they weave in Alex's scientific foundations and best evidence.
You can find more about the healing work she is doing for the community through Instinct Healing here. Please check out our special Q & A and the workshop we will be conducting together at the end of this month, which you can find out more about here.
1) TGM: I find your background as an occupational therapist and yoga teacher so complimentary. I wonder if you could tell us a bit about what drew you into OT and yoga?
AR: I fell in love with occupational therapy’s harmony between science, holism, and motivation+behavior when I shadowed OTs and PTs my junior year of high school. The OT I shadowed prioritized taking time understanding each client’s unique challenges and hopes. Compassion infused her knowledge and skills as she centered a whole-person approach in every intervention and home exercise program. This method intrinsically motivated clients in overcoming life altering challenges, and it filled me with hope and determination. That’s when I knew I wanted to be an occupational therapist :)
Yoga entered my life in different ways at different stages. I started focusing on yoga as a holistic healing modality when I was recovering from a traumatic amputation. About 4 years into my OT career, I was volunteering on a land reclamation project in the Cascades when my hand was crushed in a log splitter. My body suddenly became a painful and often terrifying place to be. Gentle yoga, breathing practices, and sensory integration gave me a way to move and be in my body and external environments again without pain or fear. This mindfulness triad gave me a bridge for feeling at ease in my body while living my life as a whole person again. I was doing my occupational therapy (hand therapy) every morning and yoga practice every afternoon for about 12 weeks when it became abundantly clear how beautifully these practices compliment each other. I completed my 200 hour yoga teacher certification less than a year after the accident followed by 500 hours of yoga therapy training at Loyola Marymount University shortly thereafter.
2) TGM: Who are the teachers/ mentors that have influenced your teachings/ clinical perspectives the most along your path?
AR: My first therapist and mentor, Jan Wheeler, PhD, for showing me how nonjudgmental, patient awareness of sensation can facilitate a healing relationship between body and mind.
My yoga teachers Amba and Don Stapleton, PhD, for the way they model curious wonder and apply synthesis of science and mysticism in their yoga method.
I recently began a trauma-informed yoga course by Zabie Yamasaki, M.Ed., RYT, with contribution from Jessica Schaffer regarding trauma’s impact on the nervous system; although I’m relatively new to their teachings, what I’m learning is already evolving my approach in an exciting, graceful direction.
3) TGM: I also teach yoga, and when I am in yoga study I miss the foundation and steadfastness of scientific concepts. When I am in physical therapy courses, I miss the poetry and holistic sense of yoga. Do you find OT and yoga are complimentary? Have you uncovered ways in which the two lenses intersect?
AR: Ahhh, Trina, I love this question so much. There’s no way I could deny the complimentary relationship between the two. Therapeutic yoga is designed to calm the nervous system and create unity between a person’s body, mind, and spirit. This lays a foundation for feeling safe and empowered within one’s body. The occupational therapy process relies on a person’s ability to use their body to engage in activity; the ability to feel relatively safe in one’s body is fundamental to that process. So I think of yoga as very effective preparation for, simultaneous compliment to, and maintenance strategy following an occupational therapy program.
4) TGM: How did you become specialized/ interested in working with the sensory system? (Were there personal experiences or gaps in your clinical knowledge that was not meeting your desired outcomes?)
AR: Sensory integration is a therapeutic approach developed by occupational therapist Jean Ayers, PhD, OTR in the 1980s; learning how to use it as an intervention was part of my OT training. The American Occupational Therapy Association (2008) describes effective sensory integration as a person’s ability to register and process sensory information for self-regulation.
Following my hand trauma, unexpected touch, sounds, and sudden movement sent me into fight-flight-freeze response. This was happening because our sensory systems are designed to provide information about what is safe and what is potentially dangerous within the environment. And until I was able to register, process, and integrate the sensory information in my environment AND within my body, everything felt dangerous all the time.
When sensory input is perceived as a threat the brain’s survival circuits are activated. Without effective sensory integration, the central nervous system can become so overwhelmed by this ongoing activation that it gets stuck in a state of fight-flight-freeze. Gentle yoga was the modality that allowed me to access neutral, spacious awareness of overwhelming sensation, and down regulate out of the fight-flight-freeze response. And it was probably my most healing sensory integration strategy.
Connecting the dots between SI, yoga, breathing, mindfulness meditation, and my own healing continues inspiring me to share these techniques with others as a way to feel safe when danger isn’t iminent.
5) TGM: I wish everyone knew about the concept of bioplasticity, and that their bodies are capable of continual change. If you were to pick three concepts you would like everyone reading to know about their sensory healing, what would you like to say?
AR: Ahh, another question that makes me swoon! This answer is coming at you
through a trauma-sensitive lens, however, I find these strategies appropriately generalizable to all of us who experience overwhelm.
i. Movement that feels safe can be a gateway to relaxation. Most of my clients can’t remember what it feels like to be relaxed, and some report having never known what it feels like. We use customized gentle yoga sequences followed by personalized guided body scans to access relaxation sensations.
ii. Developing non-judgemental awareness of sensations associated with relaxation, neutrality, and stress can be an empowering tool for stress management. The National Institute for the Clinical Application of Behavioral Medicine (NICABM) refers to this as knowing one’s Window of Tolerance. Sensation used in this practice becomes a natural, automatic feedback mechanism that informs action toward compassionate self-care and shifting oneself out of the fight-flight-freeze response.
iii. Noticing sensation can be overwhelming, especially for people who’ve had traumatizing experiences. So it’s important for anyone engaging in sensory healing to know that there is no right or wrong way to participate in these practices. Every practice is your own, you are always in control, and you are empowered to stop or modify any practice at any time in order to take very good care of yourself.
6) TGM:Do you think therapeutic interventions will get more brain / nervous system biased over the next 50 years? How do you hope to see occupational therapy evolving in the next 50 years?
AR: I honestly can’t envision what anything in the healthcare or wellness fields will look like in the future. Everything seems so up in the air right now it feels strange even forming a guess. That said, I do have a lot of faith in humanity and that goodness, kindness, and compassion will always be accessible from health care providers no matter what the future holds. I hope to see more civic and big tech investment in providing person-centric health care services in low-income and unhoused communities.
7) TGM:During these past couple years, we have been challenged to take our offerings online. I am impressed by all of the teachings you are offering online. Can you tell us a bit about how you are working with clients online, and how people can work with you/ find you?
AR: The services page on my website instincthealing.com.
You can also schedule a free consultation here or reach me by email at alex@instincthealing.com
I work with people one-on-one on an ongoing basis. This customized process is by far my favorite thing I do because it gives us opportunity to work with present experiences and co-create a tailored therapeutic approach toward your unique goals.
Fall 2021 I launched an intensive body-mindfulness program for developing resilience over stress. I’ve learned so much this during this first cohort, and I’m super excited to keep learning and maximizing the impact of the sensory integration practices. People are already signing up for the Spring 2022 cohort so, if you’re interested, now’s the time to get on the list because spots are limited!
Every quarter I guide the Instinct Healing Self-Care Club. We have weekly small group meetings for 6-8 weeks (duration depends on the topic), during which we learn from each others’ experiences what works, what doesn’t, and the factors that influence our individual healing processes. Each meeting ends with a customized mindfulness practice. You can join the waitlist for the Spring 2022 Self-Care Club here.
Every Monday evening I lead a gentle yoga class followed by a restorative breathing practice. These classes are perfect for anyone looking to slow down and soothe your nervous system. Low-impact movements are intentionally designed to increase capacity for easy breathing, calming the mind, and feeling safe and supported within your own body.
And, last but not least, I share seasonal practices and my favorite real-world mindfulness strategies in my newsletter: Practicing. Sign up here.
It has been a profound honor answering these thoughtful questions, Trina. Thank you sincerely for inviting me to engage in this conversation.
TGM: Thank you so much for lending your expertise, thoughtfulness and curiosity to our exploration of sensation Alex. I love the work that you are creating and offering people. I hope everyone checks out Alex’s site. She has offerings that are both unique and incredibly important. I may be going out on a limb, but I think that Alex's offerings and insights are the future in therapeutic practices.
I also encourage everyone that is interested in learning sensory techniques to attend our January 2022 workshop with Alex. You can register here.
Cheers,
Trina
REFERENCES by AR:
The American Occupational Therapy Association. (2008). Frequently Asked Questions About Ayres Sensory Integration®. https://www.aota.org/-/media/Corporate/Files/Practice/Children/Resources/FAQs/SI%20Fact%20Sheet%202.pdf
Image From Andy's Jogging Route Near Cleveleys/ Blackpool, England