3. REPRESENTACIONES DE CIUDAD DE LOS ESTUDIANTES DE LA
3.3 SEGURIDAD CIUDADANA
ports therapeutic change by setting the conditions for transformative emo- tional, perceptual and behavioural patterns by a mindful therapist or heal- er as they promote this same state within their client. Improvisational Dy- namics offers a way to train healers to observe, understand and take thera- peutic action in order to assist a client who is in need of moving out of their habituated comfort zone in order to pursue transformative change (Ryan, 2014). Within a coherent and comfortable environment, the nonlinear dy- namics of behavioural self-organization is a multi-scale system influenced by brain-body-spirit-world, (Champagne, Ryan, Saccamondo, & Lazzarini, 2007; Lazzarini, 2004, 2005; Ryan, 2009).
MSE’s (Messbauer, 2010; Messbauer & Ryan, 2013) provide a therapeutic space that is filled with positive approach coping cues for clients who do not have the capacity to self-regulate their emotions. Personally meaningful music, visual, movement, touch, and pressure sensations are all promoters of self and self-in-environment awareness (Messbauer, 2010). Multi-senso- ry integration cues may be thought of as foundational for coping with physi- cal and emotional life changes (Nardini & Cowie, 2012). Examples of the strategic thinking and problem-focused coping achievements that can be mastered after emotions are self-regulated within a MSE include:
• Improved eye-contact
• More neuroadaptive visual scanning of environment • Increased attention to eye-hand tasks
• Enhanced communication
• More complex occupational participation patterns • More complex occupational performance patterns
The timing and synchronisation of a variety of multi-sensory inputs has been shown to influence the brain circuitry. It increases a person’s ability to perceive natural cues from their environment (Schmitz, De Rosa, & An- derson, 2009). This is believed to occur by reducing the distractions of cog- nitive “noise” that prevent clear perceptions of the external environment (Collier, McPherson, Ellis-Hill, Staal, & Bucks, 2010). The first neuroadap- tive responses observed in clients receiving treatment within a multi-sen- sory environment are a more positive affect, improved sleep and more reg- ulated circadian rhythm cycles (LeGates, Fernandez, & Hatter, 2014; Mess- bauer, 2008).
Problem-focused coping, self-motivation, decision-making, and perfor- mance may all be enhanced by first matching the client’s internal emotion- al state and then appropriately shifting multi-sensory integration cue in- tensity (Messbauer, 2010). An adaptive response within each MSE category offers its own type of self-organising cues. This is why therapeutic envi- ronments for clients with dementia are commonly referred to as implicit memory environments. Figure 1 and 2 demonstrate examples of the use of implicit memory cues in physical environments adapted to promote spatial navigation and generative engagement in people with dementia.
FIGURE 1. Implicit Memory Environmental Cues
Used with Permission: Morning Pointe of Lexington East, Kentucky.
FIGURE 2. Implicit Memory Occupational Context Cues Used with Permission: Morning Pointe of Lexington East, Kentucky.
On the cognitive scale of emotional self-regulation, MSE treatment can be thought of as dampening the fight-flight-freeze response, reducing the negative coping patterns coupled with this response and decrease unde- sired and currently constraining behaviour patterns. Figures 3 and 4 il- lustrate MSE’s designed by Linda Messbauer and currently in use in the United States. The American Association of Multi-Sensory Environments (AAMSE, n.d.) is the regulating board designed to ensure quality control of treatment within these MSE’s. AAMSE is currently striving to overcome the challenges of practitioners, administrators and the U.S. health care sys- tem not yet recognising that special training is required to use MSE’s well in treatment and therefore is required to develop accurate data sets for cod- ifying MSE treatment results (http://www.aamse.us/).
FIGURE 3. MSE Environment
Used with Permission. Photo taken by: Linda Messbauer, OTR/L., Sensational Environments.
FIGURE 4. MSE Environment
Adaptive responses are involved in neuroplasticity or brain rewiring. Neu- roscientists propose that three internal states or conditions must be pre- sent at the same time for brain rewiring to occur (Sara, 2000). Psycholo- gists agree that motivation, ability, and a personally relevant cue must be present for developmental learning to occur (Fogg, 2009; Unsworth, Spill- ers, & Brewer, 2011). In treatment, these are called therapeutic cues and can serve as self-motivators. Specific types of therapeutic cues will be discussed within the context of MSE treatment.
Natural cues can be part of the environment, the occupation or the ther- apeutic exchange. Positive environmental cues that naturally generate a therapeutic response in MSE treatment include:
• Personally meaningful music facilitates whole brain energy exchanges that decentralise language, communication, sequenc- ing and decision making functions for more efficient chunking of memories during new experiential learning. This decentralisation of energy transfer can also be thought of as a global therapeutic influence on the fight-flight-freeze response through the whole brain process of self-organized criticality (Prehn, & Fredens, 2011; Eoyang, 2008.
• Aromatherapy, manual manipulation and whole body massage exchanges that facilitate the relaxation response and activate skin sensors may dampen the fight-flight-freeze response (Galvin, Benson, Deckro, Fricchione, & Dusek, 2006) through activation of pressure sensors. Since skin is our largest organ with a variety of types of sensory receptors, it plays a strong evolutionary role in oc- cupations associate the stress reduction, pain mediation, normali- sation of muscle tone for flexibility, sociability and healthy commu- nication patterns (Bundy, Lane, & Murray, 1991).
• Optic projector lighting exchanges that serve a central role in neuromodulating a affect, sleep and circadian rhythms. It can also be a target for working with a client on developing smooth eye gaze and exploration of space for navigation (Changizi, 2009; LeGates, Fernandez, & Hatter, 2014).
• Vibro-acoustic exchanges that serve a central role in nerve and sound conductivity for vestibular-bilateral integration benefits through the vestibular-auditory-visual triad that supports all moving, listening and looking skills (Kawar, Frick, & Frick, 2005). It increases potential synapses for neuroplasticity by simultane- ously combining two interrelated sensory inputs for multi-sensory integration.
• The self-organised occupational performance patterns that emerge following neuroadaptive sensory responses are commonly emer- gent and unconscious behaviours tied to the energy transfer of action systems within the brain. Action systems are brain networks with a neurobiological and human evolutionary purpose (Ogden, Minton, & Pain, 2006). Sensorimotor, emotional, and cognitive responses are shaped by these self-organising action systems. Some action systems activate the response to threat. Other action systems “stimulate us to form close attachment relationships, explore, play, participate in social relationships, regulate energy (through eating, sleeping, etc.), reproduce, and care for others” (Ogden, Minton, & Pain, p. 108).
Eight different action systems and their descriptions of each can be seen in Table 1. The blending of action system networks influence all unconscious action-oriented behaviours and begin with an adaptive response. Action systems are a strong influence on the psychomotor and affective aspects of experiential learning.