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About Dynamic Sensory Integration Therapy for Professionals

 

Dear Colleagues,

 

In recent years, more and more is being written and said about forms of therapy that, in addition to engaging with the emotional and mental processes of children, also pay heed to their primal desire for movement.

 

These schools of thought connect the workings of the imagination, the processing of trauma and the promotion of mental harmony and maturation with forms of play that are based on the types of movement children usually engage in – and they provide a possibility of healing through them.

 

 

Ever since the dawn of the human endeavour of healing, the space in which healing and transformation may take place has always played an important role along with the prescription of specific physical activities, or possibly complete rest, for the patient. Various ages and cultures employed varied emphases in this regard. In archaic forms of healing, particularly in the shamanic arts, movement and dance were emphasised along with a series of very specific, yet abundantly symbolic “journeys” in order to access the resources, the “spirits”, of remote worlds.

 

 

We should also note that when the healer places the person wishing to be healed at rest – as in the modern practice of psychoanalysis – “journeys” also take place into the world of dreams and fantasies, which are characterised by archaic experiences of space and forms of movement such as flying, floating, falling and spinning. Fables, those wisest healers of humanity, are also characterised by taking, flying, dropping, throwing their heroes into extraordinary spaces filled with surprises. There, the perception of space is influenced not only by gravity and the three dimensions but also be emotional effects such as proximity to or a sense of cosmic distance from a loved one, and the motif, somewhat difficult to explain, that the heroes of fairy-tales are constantly driven to explore new worlds. Instead of remaining in a safe place, we see the desire to travel in a challenging space, which results in even “youngest sons” becoming healthier, stronger and more loveable.

 

These experiences and adventures are important, even indispensable for adults, and they are all the more so for growing children whose very form of life is to explore and take possession of Space, the Universe, in playful movement, with all senses wide open.

 

And yet, when modern therapies for children emerged in the first half of the 20th century, the layout of therapy rooms took little account of these fundamental features of being a child. In many cases, the situation still shows no improvement. The average child psychologist’s office is small – though we like to call them cosy – we feel lucky if they are crammed full of toys, and all the walls are taken up by cabinets and the desk. There’s hardly any room to move. These therapy rooms, which don’t really take into account the child’s way of being, are, in effect, a reflection of the way we use space in today’s cities, which have no room, either literally or symbolically, for playful, adventurous discovery of the world. So, in that sense, the therapeutic efforts of the age, instead of offering a contrast with prevailing deprivations, tended to recreate them.

 

The American neuropsychologist A. J. Ayres was a real pioneer of seeking new approaches. Her first comprehensive summary of her work (Sensory Integration and Learning Disorders) was published in 1972. In the therapy room, she offered a world and a way of using space to children that had always been available to their ancestors and contemporaries living close to nature. Hammocks, various swings, huge rubber balls, toys that challenge the sense of balance – these days, they are all run of the mill equipment in child therapy. And yet they will always remain special, because they are able to transport both children and adults to a world of marvels, play and creative self-healing.

 

Ayres achieved remarkable results primarily with children with learning disorders, the so-called partial dysfunctions. She used her own theory of sensory integration to explain the link that exists between insufficient processing of sensory information from the environment and one’s own body on the one hand and learning disorders on the other. Learning, here, does not only refer to the process of gaining academic knowledge but also our vital ability to adapt to the challenges of our physical, social and psychological environments, which allows us to live life to the fullest from infancy to our declining years. According to Ayers’ theory, therapy needs to have a beneficial effect on the ability of children to process sensory stimuli, and the “royal road” to achieving this is the pleasurable operation of early perceptual functions – the vestibular and tactile channels.

 

Ayers’ theory and therapeutic method reached Hungary through the mediation of Izabella Varga and the Faculty of Personalistic Psychology at the Eötvös Loránd University, at the beginning of the 1980’s. As her approach was close to the ideas of the Hungarian schools of psychotherapy and education with their own valuable traditions, the theory and practice of sensory integration therapy elicited intense interest from the wider professional community almost from the very start.

 

By the middle of the nineties it was clear that in Hungary, the theory of sensory integration therapies was largely being developed in two main directions: educational approaches operating through motor training and dynamically oriented movement therapy, which also harnessed the creative powers and integrated elements of affect.

 

The personal interests, previous experiences and theoretical leanings of professionals were the main factors determining the direction they tended to choose and when they decided to make their choices. The decisions were also strongly influenced by the fact that due to the country’s recent and current history, a large number of procedures and therapeutic approaches that had been practiced for years in the west suddenly exploded into professional circles in Hungary. Here’s a small selection of those specifically working with children: the methods of Temple Fay, C. H. Delacato and G. Doman (the latter called “Foundational Therapy” in Hungarian, and promulgated by Éva Marton-Dévényi and her colleagues), the Tomatis method, Eszter Bánffy’s method, Neuro Developmental Therapy (Peter Blythe), Kiphart’s psychomotor process, the Frostig training program, Floor Time Therapy – and the list does go on. These methods all aimed to promote neurological development using diverse theoretical foundations but mostly through sensory and motor means. So there was plenty on offer – but, for precisely that reason, finding one’s way around was hard.

 

Ayres’ sensory integration therapy is based on the normalisation of the vestibular-proprioceptive and the tactile systems, in particular the recognition that those systems not only organise input about the qualities of stimuli, their potential hazardousness, the spatial orientations and their temporal sequences of the body with its bilateral symmetry, but they are also responsible for essential emotional security and the formation of social relationships.

 

That was the point at which Hungarian professionals, in whom the spirit of the Budapest school of psychoanalysis is still very much alive, found a connection between the two ways of thinking – the one based on neuropsychology on the one hand, and psychoanalysis on the other. Recall the biologically grounded pair of instincts, clinging and seeking, advanced by Imre Hermann, that was considered novel and revolutionary in the literature of psychoanalysis at the time, which involved the recognition of the importance of learning embedded in movement. Hermann’s entire oeuvre was infused with an interest in the spatial aspects of instincts, indeed, he devoted an essay to this very subject. The works of his internationally better-known compatriots, Sándor Ferenczi and Mihály Bálint are also frequently quoted by today’s dance movement therapists and bodywork practitioners.

 

Nourished by the still lively tradition of the Budapest school of psychoanalysis, the Hungarian version of sensory integration therapy, which we have decided to call dynamic sensory integration therapy, was developed. Of the many significations of the term ‘dynamic’ we would primarily emphasise that we work with a psychotherapeutic approach, in which, in addition to perceptual-motor-cognitive events, we also devote special attention to the relational dynamics of emotional events. We aim to see the world, the child’s world, dynamically, with its changes, developments, movements. This attitude also implies that we are open to multidisciplinary approaches and to integrating the latest scientific results in our work.

 

Our therapeutic practice seems to be borne out by today’s results from infant research, so we are wont to take from the work of D. Stern those constructs that explain our experiences in relation to affective tone, interactional expectations and the world of preverbal representations. We are also pleased to read the inventive summaries of the American child psychiatrist S. Greenspan and his colleague, G. DeGangi, which hint at evidence and theories suggesting connections between the sensimotor systems and emotional development.

 

For us, the decisions concerning therapeutic competency are not taken in a professional battlefield; rather, we see them as optimal decisions made in order to support the health of suffering families, which should marshal all available and effective tools. Therefore our team works on a cooperative basis, with a neuropsychologist, a SEN teacher, a clinical child psychologist, a family therapist, a dance therapist and a play therapist all having a place and a say in what we do.