The Multi-Sensory Environment, Relaxation and You

Herbert Benson, MD wrote the book “The Relaxation Response” in 1975. This book was revolutionary for its time. Doctor Benson, from Harvard Medical School, was promoting alternative medicine. Or rather reaffirming what Eastern Cultures already knew and practiced, that part of the formula for good health and well-being was self-participation in the practice. He was talking about a powerful mind/body connection for our wellbeing. Doctor Benson studied Hypertension (high blood pressure) and its connection to stress. He studied the ability of the mind to control body function (bio-feedback techniques) and especially Tibetan Buddhists and their meditation practices. He examined their unique ability to increase their body temperature; demonstrating a positive link between mind/spirit and body.

Dr. Benson stated “Human beings have always felt subjected to stress and often seem to look longingly backward to more peaceful times. Yet with each generation, complexity and additional stress are added to our lives.” This, in my opinion, is even truer today than ever, especially after international terrorism and war has entered the picture. But, this is just one example of increased stress in our lives. There are others that maybe closer to home. For example, Stress associated with an unstable financial, job, or health picture and my personal favorite time or lack of it, to name a few. Dr. Benson was talking about the relationship of stress to readers with normal coping mechanisms in his book he defines …Coping: the ability to maintain a balance in life through ones own abilities and resources. He put forth the idea that the mind could control the effects of stress by eliciting a “Relaxation Response” and that this was a mechanism that was innate to each of us; “an inducible, physiologic state of quietude.” All we had to do was “learn” to use it.

In his 1975 book he outlined four essential components that would elicit the “Relaxation Response”:
1. A quiet environment.
2. A mental device – a sound, word, phrase or prayer, repeated silently or aloud, or a fixed gaze at an object.
3. A passive attitude – not worrying about how well one is performing the technique and simply putting aside distracting thoughts returning to one’s focus.
4. A comfortable position.

In 2000, in the Foreword: Twenty-fifth Anniversary Update of his book, Doctor Benson explains “that only two components are required, the mental device and the passive attitude”, to induce the “Relaxation Response.” This change spoke to two possibilities. One, that an individual could use their mind and successfully block out noise or create imagery and thus the external environment would be unimportant, and two, the realization that a comfortable position did not necessarily mean a still position; exercise/movement could be the comfortable position. He went on to say “the Relaxation Response could be evoked with any number of techniques, including Yoga or qigong, walking or swimming, even knitting or rowing.” (I’d like to point out; this is repetitive doing, a physical action repeated many times without regard to the end product.) He said, “People were encouraged to elicit the Relaxation Response in ways that were meaningful to them.” (Notice the words meaningful to them it becomes critical in appreciating one of the principles of Multi-Sensory Environments/Snoezelen Approach, but more on that later). In essence, describing the intact normal functioning person. He further studied how important the role of the belief system of a person also contributes to his positive wellbeing. Doctor Benson and his colleagues proved that the “Relaxation Response” was effective in treating hypertension, headaches, mild and moderate depression and anxiety to name a few.

I wondered about the individuals who do not have the cognitive capacity or normal coping skills to produce a “Relaxation Response” for themselves, or use their mind in such a powerful way. I wondered if I could help produce this “Relaxation Response.” I wanted to help reduce “stress” in the folks I was seeing so I could be successful with treatment.

I went back to look at the study of the Tibetan monks again to see if there were some common threads. What I found was the following:
• The monks lived in isolation. They were alone much of the time.
• They lived in natural settings. They were usually surrounded by nature.
• Their basic human needs were provided for. (Shelter, food, clothing and no need for money)
• They had no apparent stress. (No job requirement, family or time constraints)
• And most importantly, this was a lifestyle they individually chose. No one was forcing or demanding that they live this lifestyle.

As I looked at these common threads I realized that the “external environment” was playing a significant role, and so was their right to “self-determination.” Essentially the monks had control and they were living in a relatively stress-free environment. If we look at the trends today, we can see how alternative medicine and good health/wellbeing practices have entered our Western society and are promoting positive attitudes towards new helpful practices. Everything from Yoga, Tia Chi, Pong Sway, even stress management workshops , computer generated stress breaks, and corporate “naps” are common and have entered mainstream society. Schools and Corporations are incorporating such practices because it affects the bottom line. Students learn better and employees are more productive. However, there is still little being done that addresses the environmental stress factors unless it affects the corporate bottom line directly. Take for example the design of Assisted Living and Nursing Homes. They look more “home-like.” Have you seen a Sunrise Assisted Living Center? It looks like it came right out of “Gone with the Wind,” even a giant spiral staircase, takes your breath away. I want to move in tomorrow and head right to the ice cream parlor.

The environment is being designed to reduce the stress of the family having to put a loved one into a facility. I feel a lot better about a place that is visually pleasing and may evoke pleasant memories. And of course, the corporation doesn’t mind getting your money either.

For instance, Wal-Mart’s marketing strategies get you in their environment/door. They took out the aggravation/stress of sitting in traffic, going to the bakery, bank, clothes shopping, kids photos, hair dresser, eye doctor, medical screenings, cleaners and grocery shopping and for your convenience put it all under one roof. In most stores there is an eatery and an area with video games to occupy the kids. In some States they even sell gas at a price that will beat any pump when using a Wal-Mart card! These practices increase their profit. They are manipulating the elements of stress in your life and saving you money at the same time! Every Wal-Mart associate greets you with a smile and “Can I help you?” It’s the Disneyland of retail shopping! Smart marketing! In essence, they changed your behavior by reducing your stress and giving you choices by the design and function of the environment (their store). They made life simpler, less stressful. It also helped that they lowered prices! The Multi-Sensory Environment/Snoezelen concept does the very same thing for people who have difficulty coping with stress on their own. It puts it under one roof.

So far we have been talking about stress and how there are many relaxation techniques for reducing that stress by using our mind/body and manipulating the external environment. It would seem we need very little in the physical environment to achieve this relaxation state, just a conscious willingness to devote time and effort to the practice. We may need a coach to help us practice. If this is the case we will often join groups to help us devote time and effort to practice the activity. A gym class, yoga class, etc. Although this may cost money, we consider it an investment in our future health and wellbeing and often it has the added value of a social experience.

Look at the external environment or physical environment to produce relaxation for a moment again. What elements are required? Here too the uniqueness of the individual, the personal preferences (let’s start to call this the “sensory diet”) and life’s personal experiences are going to shape our choices. If I list some external/physical environments, which would you select for relaxation? The beach, mountains, a park, golf course, stadium, living room, bedroom – these are some of the many possible environments. The activities may be a ball game, watching TV or a movie, playing video games, sitting in a sauna, having a massage, traveling, camping, hiking or sunbathing. We combine an environment we like with an activity we like to reduce stress and relax. Our sensory diet! No brainer, right? Like a vacation. We even prioritize our wishes based on cost, time allotment and distance to the personal effort it takes. One could just say, to the reality of our situation and circumstance. We do seem to have some control over these variables. One could also say that there is a relationship between environment, activities and money to the state of relaxation. So, it would seem the more financially secure you are the more you can afford to relax. But, that is not necessarily so. Look at Howard Hughes and Michael Jackson and some other current celebrities; money and external environment comforts cannot buy balance of the internal environment.

So what do we do to help people learn to cope who are suffering from anxiety and stress? We set up an artificial environment that acts as a distracter and is a place that an individual can go on vacation, emotionally. We transport them into this setting by using multi-sensory input to manipulate them. We then give them control of this setting to adjust the right elements (sensory diet) of this relaxation process – and wait. The empowerment that happens produces a state of feel good chemistry…pleasure. The pleasurable state allows for insightfulness, for experiencing calm and peacefulness. The MSE becomes a destination, like the beach vacation, the reduced stress allows us to try new activities or explore new places. Our subconscious mind may even become available to us. We even cope better with our realities because we feel safe and content, and our environment is predictable and empowering. And as previously stated, we may need that coach to help guide us through but, this becomes the added value of a helping relationship and a trust scenario developing.

Artificial Multi-Sensory Environments are predictable, safe, quiet places that produce states of mind that are stress-free and open to change. These environments should be researched and standardized, and utilized to help individuals who, for whatever reasons, cannot cope with high levels of stress and anxiety that interfere with their lives. Multi-Sensory environments are presently being utilized with special needs individuals, developmental disabilities, autism, dementias and Alzheimer’s and traumatic brain injuries. In MRI rooms, dentist offices, nursing homes, special education schools and community recreation centers to name a few. Some additional suggested areas are: Palliative care and
hospice, post traumatic stress disorders and the military, pre and post surgical situations in hospitals, preventing ICU psychosis, substance abuse groups and mental illness situations. And anywhere that individuals are restrained, the MSE, I believe can make a difference and help reduce the dependency on restraints.