Transcript for

Episode 110:

Spinning and mental health II: a conversation

You know how at the end of every episode I invite you to a discussion thread in The Flock?

Well, there was some really interesting conversation about episode 102, on spinning and mental health, which aired in early May. In the episode I talked about some of the resources linking handwork to happiness and healthy brains.

One of the responses in the thread included this post from Susan, who is a Guild Shepherd and a retired occupational therapist:

My husband and I listened to this together while running errands this afternoon. He really appreciated the endorsement of bilateral activities for brain health. This led to another ongoing conversation we have had over the years about the lack of recognition for the profession of occupational therapy, which I entered as a student in 1989 when weaving and crafts were still included in the curriculum. Mine was the last class at Colorado State University to include education in crafts as a therapeutic modality. The origins of the profession, which heavily drew on theories related to meaningful purposeful hands-on activities as a therapeutic modality, were lost to the demands for corporate profits, shorter and shorter hospital stays, and as Sasha mentioned the reliance on psychopharmacology as the sole reimbursable means to treat mental health problems. My education taught me that pharmaceutical treatment was a means to help people become stable and emotionally engaged enough to participate in therapeutic activities. It was an adjunctive treatment at one time and had proven effective. . . . I just wanted to let people know that the research you’re hearing about now has decades of prior investigation by OT’s as well as psychologists and other mental health professionals. Insurance companies are beyond reluctant to pay for treatment focusing on purposeful meaningful activities as a path to healing. Maybe this latest spate of investigations will change that. Imaging sitting with a mental health therapist in a small group setting where everyone is working on a project of their choice with the therapist guiding the conversation, setting limits, and allowing patients to talk or not talk while they process their issues. This was also an occupation therapy clinic back in the day.

Then another shepherd in the group, Suzanne, chimed in and reminded me that she's done some research that uncovered some other studies on the links between knitting and both mental health and learning. And so asked Susan and Suzanne if they would be willing to continue the conversation on the podcast and I'm very happy to say that they both agreed. So I'm delighted to introduce Susan Crosby and Suzanne Reyes, who are here to talk more about all of this.

[4:39] Yes. So, Susan, can you start us off by first saying a little bit about what occupational therapy is, because some people might not know, and then talking about how occupational therapy has used what you call purposeful hands-on activities as a mode of therapy? Okay. So.

[5:02] In a nutshell, as much as I can make a nutshell out of a really complex and far-reaching profession, it's a rehabilitation profession in the healthcare framework that works with people of all ages and various levels of disability or ability. With the idea that we are either helping people to gain or we're restoring a level of function that allows them to participate in their life skills at the level that is meaningful to them. So for a very young child, their job is play and socialization. And if they have a developmental disability or a physical disability or an injury, such as a head injury, that prevents them from being able to engage at that level, then we work on skills that allow them to re-enter that sphere of childlike experience. For an older person, it can be anything from being able to wash their face, say they just came out of a coma, and their very, very basic self-care skills would be holding a washcloth and washing their face, and doesn't that make us feel human again?

[6:17] And all the way up to being able to drive again after, say, a head injury or a stroke. There are occupational therapists that work in the agricultural community helping people who have lost a limb to a farming accident to get back to being able to get on their equipment and do everything they need to do despite that loss of limb. So it's pretty broad-reaching. The idea of purposeful activities is that we use, All sorts of modalities, including routine, very rote exercises, all the way up to something that could be complex like operating a computer or a lot of occupational therapists are using virtual reality as a therapeutic modality. But we're engaging people at that level where this is meaningful to them.

[7:08] So I wouldn't say, okay, Mr. Smith, you've been a car mechanic all your life, and now your right hand doesn't work because of whatever your disability is. So what I'd like you to do is start needlework, start knitting, because that's really going to get that hand going again. And I might get a look like, I don't like knitting. I don't think that's gender or age appropriate. people would make fun of me. That doesn't relate to what's important for me. Even though knitting might be excellent for that person, it has no meaning or purpose for him. So for him, I might say, okay, what I want you to do is, what does your workbench look like out in your shop? Because he's a mechanic, he likes to do stuff like that. It's a big mess. I can't find anything. Okay. So when you go home today, what I want you to do is spend 30 minutes, 45 minutes each day this week until I see you next week. And I want you to sort all the stuff on top of your tool bench and put things in jars and boxes and hang them on pegs to the best of your ability.

[8:15] But each day he's doing something that really means something to him. And he knows he needs to do this. He probably should have done it years ago. And so his mind and his body are engaged in that activity. So he's going to get more benefit from it than if I say, I want you to do this thing that has no value to you. One, he won't follow through. And two, because his brain and his emotional body is not engaged, he will not get the same benefit.

[8:42] So that's where occupational therapy comes in with functional activities that are meaningful and have a purpose for that person. Okay. So in what context, can you sort of give us a context in which you would say teach somebody to knit or encourage them to start knitting again if they already knew how? One, I would need to have enough time with that person, which is a huge limitation in all health care professions, including your doctor, who only gets seven minutes with you.

[9:19] You see everybody in the office much longer than you see your actual physician. So I would need to have that time with that person. And then I would do an assessment. One, is that going to be possible for them? Two, are they interested? Mm-hmm. Three, do they have the cognitive ability to process this? It may not be the level that they're at right now, but if they are and they say, you know, I've always wanted to learn how to knit. My mother knit, my grandmother knit, all my friends knit. I'm the only one that doesn't knit. This would be really fantastic. Then I would use knitting for that person as a therapeutic activity, because it's their goal. It has meaning to them. Okay, great. As I said, I would need the time, and yeah. Which you might not have. Which I might not have, which will take us to some of your other questions. Why aren't, why isn't handwork or crafts used more frequently in rehabilitation settings? Yeah. Okay, well, we'll come back to that. So, let's put a pin in that.

[10:27] Suzanne, can you tell us a little bit about the research that you've done about knitting and craft and mental health and learning? Sure. Yeah. So just to give some background, I spent a year actually, which was like two academic semesters, you know, so academic year, which something called a project improvement leave that a lot of people might be known as a sabbatical. And um and basically i had like some different uh aspects of my research and one was to just do a lot of research and create this i created like a 29 page annotated bibliography so that all of my colleagues in the different disciplines could really take this seriously and basically my goal was to find ways to make connections between like if students had outside handcraft i focused on handcrafts just because of some of the benefits that we're talking about like what susan started talking about and I'll tap back into mostly mental health benefits.

[11:28] But I wanted to get students like interested in doing outside activities, you know, hobbies that they dealt with using their hands in a non like virtual, non-techno technological way, since that seemed to be part of the issue is that people are like on technology too much. But I also wanted my colleagues to really take it seriously that they could Like they could make connections between different readings that they were discussing in their classes or different, like maybe in the sciences or math, different projects that they were doing. They can make connections to these outside activities that I was hoping to get the college to kind of sponsor me and creating some extracurricular avenues, you know, for students to learn some of these. Or if they had already started to do some, to have a place, you know, to come and meet people, which I have kind of started on that a little bit, but that's not taking up as much as I wanted. And I also created a toolkit, like for the teachers, so that they would have resources that they could use if they did want to do tie-ins to the class.

[12:33] And one of the tie-ins that I, I found so many, I mean, like I said, I have a 29-page annotated bibliography. I have a list of like all these different websites and videos, things like on PBS, Craft in America being one of them, if you guys have heard of it, things that they could, you know, show their classes, little snippets of and that type of thing. But one of them that connects to what Susan was just saying is apparently back during like the World War, I think it was World War II, but maybe even World War I, when these veterans like came home from the war and they were in rehabilitation settings, like dealing with loss of limbs, you know, different things that Susan mentioned, but also post-traumatic stress, which they wouldn't have called it at that time, but, you know, shell shock. They actually did use, they use knitting techniques.

[13:26] They used, I think, other types of needlework. I know for sure knitting was one of them to help rehabilitate these men. And it really was very effective. Like the research has shown that it was very helpful to them. And then like going forward into this time, I have just tons and tons of research that I came across for many of the different hand crafts. Knitting comes up quite a bit, but like embroidery, quilting, like just a lot of different things. woodworking.

[13:55] But the other aspects, so that's all for mental health and, you know, just more of like a physical health benefit, but also to the learning. I mean, that was what I was really interested in because I felt that students probably by doing these like outside extracurriculars would gain all kinds of skills in learning something new without fear because it's something fun that they could then transfer to their actual learning. And I did find, so I'm going to share with you, um, this one, um, this one, uh, article that's really just powerful. Um, so it's, it's from this, uh, University of Ortega in New Zealand, and they, um, had a study of 658 adult students, when they say adult, they mean like 18 and over, using a 13-day daily diary method of study. And in this study, the researchers found that like other interventions, such as meditation.

[14:59] Exercise, yoga, that kind of thing, gratitude journals, everyday creativity, just like those others, had a positive influence on students who were struggling. So that's the mental health. But then this is the part that I just loved. Not only did it cause students to flourish, but they noticed an upward spiral where creativity led to positive feelings that were then carried forward to the next day's pursuits and continued. So they linked it to being able to be more engaged in learning in the classroom. And this was a study done by Tamlyn Connor and Colin DeYoung and Paul Silvia called Everyday Creativity as a Path to Flourishing, which I think was the other thing that really needs to be highlighted and then I'll stop. Flourishing, like it's not just to make you feel better, but to make you flourish, which to me is what helps students to really do well in school because now they're in a very positive spiral.

[16:01] So, thank you, Suzanne. And I have a lot of questions about that. I mean, did you find, other than that New Zealand study, did you find any other studies about learning?

[16:17] That was the main one about learning. But what I found, I'm sure you have all heard of this before.

[16:27] A lot of these articles that I read, though, did tap into, and I'm going to probably mispronounce the name, but Mahali Sintamahali, who's the person that discovered the idea of flow. Flow so like flow is basically essential to any of this that we're talking about because in person needs to be able to get in this state um uh it brings great happiness you know and that contributes to the flourishing um it's a state of mindfulness but it also brings self-confidence to the person which i that's what i'm kind of tying to the idea of students being able to learn better because they need to be like confident in what they're doing and i think if they realize that, hey, like when I'm doing this fun thing, even if it's sports, when I'm doing this fun thing and I make a mistake, it's okay. I learn from it. And then I like, I do better. Same thing can happen with school, you know? Oh, okay. Now I get it. Like, and process, like I'm okay doing a process when it comes to sports. Why am I not okay doing a process when it comes to school? Oh, that is so good. I once had a student who came to me, it was a second year class and it was a big second year class so there were like 300 people in it and I was doing the lectures and I had TAs doing the discussion sessions and the material was hard and I had a student come to me because she had gotten a she failed one of her assignments.

[17:56] And she came to see me and she was, you know, she was just awash in tears. And she said, I've been carrying this. I've been like, she had the essay, the fail, the failing essay in her backpack, and she'd been carrying it around with her for two weeks. And I said, OK, first of all, you need to get that essay out of your backpack. pack. But I think so many of our students in the academic context, like any kind of failure or bad mark, and those two things are sometimes correlated and sometimes not, is just such a disaster for them. And they don't see it as part of a process of learning. And so I love the idea that if you sort of put them in a different situation where they think the stakes are lower, that they can get that lesson about, you know, actually mistakes being something that can move you forward rather than something that like destroys your whole week as this poor student carrying this essay around in her backpack and just feeling horrible about it, you know?

[19:12] Yeah, that's what I would help. I mean, I'm trying to get something going more at my college i'm having a hard time with that part of it but where maybe i could get more students to experience this feeling with with uh hobbies or handcrafts so that then we could make those connections more you know like firmer but the last piece that i thought was really important was making connections between either like historical subject matter scientific math with something every day that they're enjoying and it's fun for them and so like a lot of the different like one One was like the Gee's Benz quilters, you know, so if you're talking about, let's say, African-American history and you're bringing up anything to do with, you know, maybe what women were doing like right afterwards, you know, during like the Jim Crow era or something like that. Being able to see these women who made these quilts and kind of make those connections or like one of the really big ones I found that I just loved was I don't know if you if you are all familiar with that coral, the crochet coral reef project. Yes. And the two sisters who, you know, started very small and got all these crocheters to make these little bits of crochet that are put together to look just like the Great Barrier Reef and how now it's going to museums all over the world. And I think like when the students see something like that.

[20:31] You know, they kind of, it just makes more of an impression on them what exactly is happening with the sides because they kind of have an overlap in the way that it's put together, the artistic pieces put together with how the Great Barrier Reef actually grew to be what it was. Right, right. That's, yeah, that's such a good point. And I love that you mentioned Gee's Bend because I've taught the Gee's Bend quilts in a class and everything is connected to those quilts. So, you know, slavery, reconstruction, Jim Crow, you know, urban versus rural. And it's all it's all in there. And you can talk about all of it in relation to, you know, this incredibly these incredibly beautiful objects that are made from, you know, people's work clothes. It's a yeah. So that's great. Great. Suzanne, first of all, I want to ask you if you, not Suzanne, Susan, sorry.

[21:32] I want to ask you if you have any responses to anything that, if anything that Suzanne said sparked anything for you. The phrase that came to my mind was grading activities, which is a process we do in occupational therapy where we present the activity the person who's rehabilitating needs to do. We present it at a level that we're pretty sure that they can do and then just present the next level, the next level, the next level so that they're building on those successes rather than saying, um, uh, I know that you're seeing double, but I want you to, um, you know, button your own shirt now. And, um, right. And then they can't do it. And so I might say, let's go over to your closet and I just want you to reach for a shirt.

[22:25] So, which is, it's a much bigger target. Um, so we want people to experience success so that they do have that feeling of, um, self-efficacy. I can do this. Um, and the most important thing, and this goes into this concept in occupational therapy, which is therapeutic use of self, you want the patient to like you. Because when you show up, you want them to be glad to see you and you want them to work with you. And if you've done something the previous day that has caused them to feel like, I definitely do not want to get out of bed and I don't want to see you because I feel so bad about not being able to button my shirt yesterday. That is not therapeutic and you got to go find somebody else to work with that patient. And so we, we work, start where they are. And there's also this thing called backward chaining too, where you say, okay, I'm going to do this part right here. And then I want you to do the step before that.

[23:26] So that's where I'm going. But this is the step that occurs before that. And so sometimes that's really where people need to go. And I think if you're instructing people in spinning or knitting, like with knitting, you would cast on first. With spinning, you would tie on the leader and maybe even get the fiber going first. They can see, oh, that's what twisted. Right, right. Exactly. We grade the activity with a new spinner and we don't even put any fiber on the wheel at all. We say, just treadle. Now make it go the other way. Now make it stop. Yeah. And then now let's put a length of yarn on there and just feel that feeding the yarn in. So we're grading it. So there's success. Instead of, here's your sticky Malabrigo noob, Marina, hand-dyed, gorgeous. But all of us struggle with it. No matter how long we think. But here, I want you to make beautiful yarn with this. They'll never touch it again because they'll feel like this is beyond me, right? So yeah, I think introducing that concept of.

[24:33] I was successful at this. Now let me try this next step. So I think you were talking about that, Suzanne. Is that correct? I mean, I think definitely. I mean, in terms of that, they'll get that sense from it. Hopefully what the handcrafts that they would be doing would be like simple, you know, especially at first when they're first learning it. And then they would see like, oh, I can build on this. Why can't I then build like on my writing process in the same way? I think the fact that grades are attached to the academic subject matter, and we have not been able to find a way to eliminate that. I would love it if I never had to put a grade on anyone's paper again, but we're having a hard enough time right now getting people to, you know, take the paper seriously and write them even with grades on it now. We have to be able to measure, we have to be able to measure learning. Like I have to be able to measure, is this person making progress with their self-care skills? But I think what you're talking about with handwork and learning is what we call transferring a skill. So if I can do this thing right here, and I have that feeling of self-efficacy, self-mastery, I'm going to take that emotional feeling of being capable, and I'm going to go over here, and I'm going to rise to the challenge of doing this thing that I maybe have not had success with before, but I'm going to do it again because I'm riding that tide of... Yes.

[26:02] It's so important. Yes. Yeah. Well, I think that this idea of rating and also transfer of knowledge, I mean, it really links what you've both been saying in that it's about you need to be winning at something somewhere in order for it to kind of build momentum towards, you know, a transformation and a good direction.

[26:29] Yeah. Suzanne? in. Can I bring up one other study that might relate to a lot of our listeners too? So one of the studies, I didn't focus on this one as much for my school project just because it has to do with middle-aged and older women, but I think this is really an interesting one. This one was C.E. Adams-Price and B.A. Steinman, Crafts and Generative Expression. And it has a longer title, but that's the first part of the title. And it's an article that it studied middle-aged women from 31 to 64 years. And basically what they found was the way that learning craft activities, and they focused on jewelry making in particular, how it provided opportunities for generativity, which is something that I guess, you know, they found is very important for people as they, in middle age and getting older, you know, thinking that they're like caring for and contributing to life for the next generation in some way, a principle that Eric H.

[27:36] Erickson, you know, came up with. But they found many positive benefits to women, including opportunities for sociability, self-expression, reduction of stress. Are there any situations, Susan, Susan, in which an occupational therapist would use crafts today? I know you said, and I will have talked about this in the introduction a little bit, that this is something that is kind of passed out of favor in occupational therapy. So I would love to hear you just talk a little bit about the kind of economic and historical context for that shift. Yeah, I will go all the way back Back to the mid 1700s with that answer, which is the birth of what was called the moral treatment of specifically this is people who were.

[28:31] Mentally ill, chronically mentally ill people, were often imprisoned, in workhouses, very, very mistreated, no treatment as far as psychiatry or things like that. And it was around that time that there were psychiatrists and other medical professionals that were starting to go, we need to do something different here. But it wasn't until probably the mid-1800s where the The idea of occupational therapy, per se, was really starting to become a solidified treatment modality. But it was birthed out of psychiatry, along with nursing, along with social work, along with the arts and crafts movement that occurred around that time, where we had so much industrialization going on. And the factory work was how many, many people made their livings. They went from what we know as cottage industries, where people made products to sell from home, and they had mastery of their own environments and schedule and could care for their children at the same time that they were spinning, weaving.

[29:43] Tatting, whatever they were making to sell out there. Um, so, so all those things as they move towards, uh, factory made goods, put people in a position of having to go to work, working a shift and then coming home exhausted and feeling like life just didn't have the same kind of, uh, pizzazz as it did when they were, um, in charge of their own schedule and their own households, uh, all day long. So, um, the arts and crafts movement came along saying people need to use their hands. They need to be creative. They need to engage their hearts and their minds to have quality of life. It's important.

[30:23] And that's when we saw even architecture and furniture. We all know what arts and crafts houses and furniture looks like. It's quite handmade looking. It has a lot of simple lines. So from there, the idea of having people who were hospitalized for institutionalized, which what they really were, for chronic mental health disorders, even brain injuries could be put in that category where people couldn't care for themselves anymore. more. But they started having carpentry workshops and weaving workshops and pottery and gardens and handwork with knitting and crocheting and even probably sewing. But the idea was, here these people are sitting around, it's mealtime, it's.

[31:13] Maybe go sit outside and smoke time or whatever, but they're not really engaged in anything purposeful, meaningful as far as like an occupation goes. So I think that's where that term occupational therapy goes or comes from. Many people think I'm going to find them a job. No, your job is to get dressed and let's go.

[31:34] Right. Right. So it came from that era. And then around 1915, I think, was the actual beginning of the profession of occupational therapy. There was a school, there were papers being written, there was research, there were books being published about occupational therapy. And so it really got its liftoff in World War I with returning veterans who were shell-shocked, missing limbs, they were blind, all sorts of problems. They stayed in hospitals, veterans hospitals for a very long time before they went home. And maybe some of them never went home. But while they were there, here was this idea. It's not just, we're not just going to keep you occupied during your day. We're going to use weaving to get that weak arm going again.

[32:29] You're going to reach, you're going to pull, you're going to wind that yarn around the shuttle, you're going to do woodwork, and I want you to push really hard as you're sanding because you really want to get that bicep and tricep thing going again. So it had more science behind it as there was more understanding about human physiology. But at the same time, the medical model of healthcare was really becoming much more dominant, and that that idea of reducing a person's illness to body parts even a a mental illness it's like well you don't have enough uh dopamine you you don't have enough serotonin uh there's there's a deficit and we will do this with a with a pharmaceutical to to place that and so that's That's fast. It's easy. You can do that as an outpatient. Sometimes people need to be hospitalized for their own safety or for the safety of others. But oftentimes, chronic mental illnesses in that era could be managed with pharmaceuticals. Well, the same thing was happening with physical disabilities as well. This idea of body parts being like, it's like you're a mechanical piece. So if your arm isn't working, well, let's just do some exercises.

[33:57] Forgetting that maybe up here, the person doesn't see the point anymore. Right. Right. So I want you to do these TheraBand exercises. And here's the sheet this many times a week. I know it's terminally boring, but you need to do this. And I'll see you next week. Um, so, so that's the part where occupational therapy has been kind of been forced into that, um, biomechanical frame of reference. And it is a valid frame of reference. It's also the psychosocial frame of reference too. There's actually many, uh, frames of reference. I think there's five. I can't remember them all. I've been out of practice for a while, but, but we want to continue to look at what is meaningful and what is purposeful for that individual. Individual um i think you asked one of the questions you asked me is why don't um why aren't handcrafts prescribed for uh treatment i think it's very difficult to do that it's time consuming um i i was having a conversation earlier on one of our guild coffee dates about um this person read a book and the the doctor told the the woman in the book to um To start knitting.

[35:14] And that just makes me laugh because I think, well, when I was practicing OT, I also taught therapeutic yoga and doctors would send their patients with chronic pain to me for yoga class. And it's like, okay, that's good because I can actually do a full analysis of like, where is the problem and what are your limitations and where do we need to be careful and where do we need to push? But if you say, oh, you have back pain and this study says yoga is really good for arthritis of the bath. Go do yoga. Where? With who? I can't get a bit of time from the floor. What are we talking about? I don't like yoga.

[35:55] So this is where we get into this reductionist perspective of just apply this therapy or this medicine or whatever to this problem when we forget there's an entire person with goals and aspirations and, and, and a social support system or lack thereof. And like, where do they live? Who's their friend? Who, who, who loves them? Who do they love back? What's important to them? Do they pet? You know, where, where are we going with all this? I want to do yoga so that I can squat down on the floor and clean my kitty's litter box and put wet food in and get down and pet her. That is important to me. Okay, let's go. Let's get some stuff for the quadriceps. Let's go. And we're going to get up and down from the floor and we're going to figure out how to do that. So that's where I think we have to be much more cognizant of that it's a human being. It's not a car. Right. But at the same time, we have insurance companies dictating how many visits you can have.

[37:06] In most situations, it's six. And if a therapist wants to continue it, they have to show progress and they better have a good treatment plan to follow it up. If you're admitted to the hospital, three days. I don't know how it is in Canada or in Europe, but in the U.S., you get three days. And after that, the hospital's not getting paid as much.

[37:28] And people are grouped according to their diagnosis. And depending on that diagnosis, that's how much the hospital gets paid. So they're they're they're moving people out really quickly and so you're seeing people in um at home for home health they have no business being there i don't think right yes or they're discharged to a nursing home for rehab it's a nursing home excuse me i'm 65 years old i broke my hip this is flipping depressing um get me out of here as soon as you can. So we have all this shuffling around. And every time you get moved, you have a different health care team. And it's just so fragmented. It's really hard to do anything. It's truly holistic when you're getting reimbursed by insurance. Right. Right. Well, what you're saying makes sense to me because I actually went through that exact trajectory with my aunt, who had Lewy body's dementia, had a bad, really bad fall, broke her jaw, had to have her jaw wired shut. And so she had her three days in the hospital and it was three days. And they took me aside and said, basically, you need to get her out of here by X time.

[38:51] And they sent her off to rehab, which was in a nursing home, which was indeed incredibly depressing. And there was no continuity of care. There was no, there was, and there was really no time or even incentive to kind of get to know her and know what her motivations would be. That's the thing that I find really beautiful about what you're saying about the OT approach, approach that there's, you know, that there's actually a whole, there's a mind here too. There's, there are social relationships and we have to kind of get at all of that.

[39:30] We have to, we have to, and, and also it's a, it's about using all the resources that you have. You as a therapist, you know, when you're, when you're able to hook into their actual lives and their actual motivations, I'm sure you get much better compliance in terms of them actually following through. Yes. Yeah. I think, you know, that I am deeply interested in other people. I call myself nosy, but that's, I think one of the things I brought to the profession was like, I am really interested in people. I want to hear their story. And I will listen to their story as as long as it's sensible. I mean, it can't listen for very long because we need to get going. But I'm really interested. What makes you tick? What are you, what do you want to do? What do you need to do? What do you have to do? Where do you want to be?

[40:25] Yeah. And linking the quad thing to the litter box, like for me, you know, that would be highly, that would make me do a lot of squats.

[40:36] Is so, you know, because that cat might have, I mean, we don't, you know, we don't know the meaning of that cat in that person's lives. But if it were me, you know, being able to keep my cats would be very, very close to the top of my list. Sign me up for yoga. I know I said I hated it, but let's try it anyway. Right. Yes. It has an outcome that I can see purpose to. Yes. Yeah. Yeah. So, okay. Okay, so we've got lots of studies, both in the OT context and then in a bunch of other academic contexts where this has been studied, that are suggesting the usefulness of purposeful, what do you call them, purposeful hands-on activities? Meaningful, yeah. Meaningful, yeah. Yeah, yeah.

[41:34] With both mental health, learning, all these, we know all these benefits, right? I mean, we don't have a lot of research, and that's something I want to get to in a second, but we do have some research, right, that suggests that this could be very, very advantageous for lots and lots of people. And I did a little research in preparation for this conversation about the rates of mental illness. And this, I believe, is a U.S. study. And obviously, there was a kind of artificial bump during COVID, where we saw depression and anxiety in particular really skyrocket. And then it sort of came down a little bit. But still, the numbers are really horrifying to me. So among young people, 36 percent, more than one in three. And among women, 27 percent were dealing in some way with some form of mental illness in 2022.

[42:42] So the levels are epidemic. Why are we not? Why don't we have like a moonshot program dedicated to exploring how these modalities could help people? Yeah, Suzanne. I mean, I'm sure I think we all have our ideas about that. So I have an idea about it. And I want to make a connection that's just purely my own. But it's kind of based on all this research I did. I feel as if we've kind of lost touch with the handcrafts as being like part of daily lives in especially in America, but I think a lot of like Western countries, because it's not done. You know, like, like for me, like my mother didn't do any of this. So it was going back to like, and even my grandmother really didn't do a lot. I mean, she, she sewed like clothes for her kids, but you know, it wasn't like a daily thing to be knitting or crocheting. It went all the way back to my great grandmother who was like doing it as a daily thing. But if you look at like, you know, history daily, it was a daily thing for almost every person, man or woman to have some handwork like going on throughout the day, because there wouldn't have been television there, you know, there wouldn't have been radio.

[43:56] Yeah, it's a certain point. So people were like doing things all the time with their hands that was occupying them going back to Susan's word of like occupational therapy. But one of the things I saw recently that really just struck me about this is I don't know if you have seen but on Netflix, they have a show that is called the Blue Zones. And it talks about these five different areas, five or six different areas where people People live like well into their 90s, even to 100, like way more than like any other populations in the world. And most of the show focused on like their eating, their, you know, their sense of community, their not exercise in the traditional sense of communities, but the fact that they're always walking and all this kind of stuff. But one thing I noticed on every single one of these ones that they showed, one was in like Asia somewhere. One was in like the hills of Italy. every single one the people were doing something with their hands throughout the whole entire day like women were there like sewing or knitting like men were doing little whittling like I mean some men were even knitting I think in some of them but like.

[45:02] They were cooking, they were cutting vegetables, like they were using their hands the whole day and you didn't see them with phones in their hands. I mean, not to say that we're against it because we wouldn't be able to have this interview right now, but they were doing hands-on like real world things. So I think people just have forgotten like how important this is as a partner. Well, it's not necessary either. I mean, we can just literally go online and buy clothing. Um you can dial up on your phone a door dash or whatever and have food delivered you know we don't it's people have lost a lot of people have lost the the skills of just making on your own because it's just so easy and convenient um but then you have to spend all this time making the money to to just go ahead and buy that stuff and maybe what you do for a living really isn't all that fulfilling. I think that might be contributing to a lot of the stress and the mental health disorders as people are stressed out, they're not fulfilled, their job is horribly boring, all sorts of things. But yeah, if you came home and you prepared the meal yourself.

[46:14] From scratch and sat down and calmly ate it with your family or even by yourself, yourself you might find that that helps to de-stress but many people have been socialized to or they just don't like to cook I won't say it's all socialized but many people have been socialized to think that um it's just I'm just gonna say more modern because that would be my mother's term to buy things that are already prepared so my mother was a huge fan of the things that came in a box or a can or frozen because she thought that was a sign of prosperity I believe. That's me. I dare defend herself. But I think that because she came from the Depression era, her childhood was growing up in not poverty, but, very much not a lot of stuff. Um, so for her to go out and be able to just buy things was a sign that, um, you know, that she had some measure of security in life. Right. So, um, and I think that that's probably carried over, uh, thanks to a lot of marketing, um, and billboards and things that, um, this is fun to just go drive through McDonald's. Right. Right. This is what we do with our kids. We reward them. Hey kids, what a great soccer game. Let's go get at McDonald's. So it hits that part of the brain that feels like, oh, yeah, I've made it in the world. I'm successful. I can just buy stuff.

[47:36] Right. I don't need to do this. Yeah. I have never been one of those people. I've always loved to cook. I've always loved to make things. And my jobs have always been, I've been able, I've had the luxury of choosing because I've been able to be educated because my brain has let me. I've been able to choose jobs in which I feel a great sense of fulfillment. I won't say that they weren't horribly stressful at the same time, but I always felt like I was doing something to make life better for other people. So yeah, that's how I dealt with things. Right. And I think also that people are working so much and the boundary between working and not working is dissolving. And the time that they would spend maybe knitting or sewing or whatever is being sucked up by Instagram.

[48:32] I'm just raising my hand here as a person who's easily sucked into Instagram. Because give me a cute animal video and I'm, you know, I'm swiping, I'm swiping, I'm swiping. Anyway, so people, I think people experience themselves as tremendously time starved. And so all of these sort of products of our more or less affluent lifestyles are working against us in this way. Yeah, Suzanne. Yeah, I mean, you just called to mind, I had a reading response blog post yesterday, I think it was from one of my students, because I assigned an article called Addicted to Distraction.

[49:17] And I can't remember the name of the author off the top of my head, but I think it's a well-known author who's written about this. And it's all about, you know, the addiction to like technology. Technology and this student wrote this great blog post where she said that she loves to crochet and this was not prompted by me so it was like she loves to crochet and she looked at her phone after reading the article because that was one of the suggestions to see how much time she had been spending on social media or different things on her phone and realized and she couldn't believe it six hours a day and she said I can't believe it because I'm so busy at work I'm so busy with school. I don't know how I've spent this much time. And what I realize is I really miss crocheting and I keep telling myself, I don't have time to crochet, but now I realize I do actually have time, but I've been doing this. So she decided, you know, to put her phone away and like pick up her crochet instead. And I thought, oh, that's wonderful. Yay. Oh, so good. So good. Well, so if I were the, if I were the director of the National Institute of Health, I gotta say I would be directing resources in the direction of like studying these incredibly low cost you know.

[50:34] No side effects kinds of interventions and my theory about why that isn't happening is that we associate these things with with women and domesticity what do you think i agree i think along with that i think it's considered a diversionary and it's a frivolous use of time, um how many articles or even um essays in like, Knitting books are, I'm thinking about Clara Parks' book full of essays, where women feel like they have to defend their purchase of yarn to their spouses, who has an enormous collection of golf clubs, because golfing really produces something useful. No, it doesn't.

[51:24] That's kind of the point of golfing. It produces a score and you have socialization and you get a little bit of exercise, maybe. Whereas over here, this collection of yarn can become a warm blanket or hats or whatever. It doesn't even have to be anything because the person who bought it is happy because they bought the yarn. Just purchasing of the art. If it's not taking from your household budget, you know, if it's not occupying an entire room of your house that really is supposed to be for your, you know, mother who stays with you every year, then it's not a problem, right? It's called a collection, like Beanie Babies or art. I think it does. It goes back to denigrating female occupations.

[52:16] As being less worthy than male gender occupations.

[52:22] And I came across a lot about what has happened, you know, to knitting, embroidery, weaving, to a certain extent, although weaving never got as much of the painted this way. But they used to be like, in my research, I came across like, especially knitting, it surprised me. I think it was I hate I'm so bad with dates but I want to say like 1600s or so and they were actually like knitting guilds and they were all men and they were it was a very professional occupation they did you know special like knitting I don't know exactly if they were called tapestries I can't remember but then once it became more women in the cottage which I think Susan referred to like the cottage industry of like women knitting that's whenever it became like devalued or um and that happens a lot of times and even when i did my my project improvement leave i really felt a very you know like strong need to try to find as many like male you know stereotyped male.

[53:23] Handcrafts as possible uh because of that but if you see like in a lot of other countries i wouldn't say a lot but several other countries that i came across especially in south america the men knit just as much as the women and and you know and it's valued and you see them on the the videos that I'm trying to like get my sociology counterparts, you know, to use, but you see them like the whole culture, they're, they're knitting these like Peruvian hats and all these incredible things. So it's not that we couldn't get more men. There's actually a.

[53:53] Uh, another video, I think it's, I think it was Iceland where there's a man who's trying to like revive, like the idea of men knitting and, and these men like sort of came out of the closet. Like they were knitting at home. They were a big part of their, you know, hobby, but now they feel comfortable because this one man has led the charge of them meeting at coffee shops and like having a group of men together knitting.

[54:17] Plus his heart. I thought that video was really good. Yeah. So, we should probably move towards wrapping up, but I want to... That's the answer to your question, Sasha. Okay. What question? Oh, wait, I have so many notes. Oh, is OT still used? Is our craft still used in OT? Yeah. Yeah. And to that, to the best of my knowledge, it's primarily with children in the school system. Not so much outpatient but in the school system i know that when i worked in schools i did a lot of hands-on crafts with kids because it was teaching them fine motor skills eye hand coordination turn taking um using using language skills instead of saying can i have that thing over there, it's like, well, what is that thing called?

[55:16] The glue? Oh, here's the glue, right? So, so many things that you can do with kids because they love to play and crafting is play for them. The other way that I used crafts all the way up through my adult physical disability career was an assessment tool, primarily called the Allen Cognitive Level Screen, ACLS, and it's a leather lacing task. And it has three, three different types of leather lacing. It starts with a running stitch.

[55:52] Then if they can do that, then they do a whip stitch. And then if they can do that, then they do what's called a single cordovan, which is what you would see like on the edge of like, say, a wallet or a purse or something. It makes a really nice edging.

[56:05] And so each of those steps gives you a, this is all standardized. It's been around, I think, at least since the mid 80s. And you look at how they approach that task. If I hand them the leather lacing with the shoelace hanging down for the running stitch, and they actually take it, that's one score. If they poke a hole with the lace, that's another score. And if they go all the way up to doing that single cordovan without any instruction from me, that's the highest score. You can look at that and you can problem solve. You can look at something and basically take it apart a little bit and then see how it all fits together. And so we're looking at problem solving. We're looking at initiation. We're looking at attention. And all those things give us a sequence. sequencing. Sequencing. What is their cognitive level? So if I get a person who can do the running stitch, they can do the whip stitch, but they don't recognize a mistake, even if I make it and hand it back to them, can you find your mistake? Can you correct it? That person who can't find that mistake and correct it, I'm going to recommend to their family or caregivers that they be supervised with their medications because I've just seen that they don't have the problem-solving skills.

[57:28] So, yeah, so it's super useful. But the whole Allen Cognitive model even includes a kit, a huge kit that I used when I worked in long-term care for residents with dementia to kind of figure out what activities are appropriate for them. There's 35 crafts and you set up this craft activity and you watch how the person does that and you're scoring how they do that. And that tells you what their cognitive level is. So you know that these tasks are probably appropriate for that person and you can educate caregivers and family members on what your expectations should be. In a mental health setting, alcohol or drug recovery setting, you would be able to start with the leather lacing, even do the crafting activity and go back and meet with the team and say, well, here's where they started when they came in. And this is what they're doing now. Most likely this person is ready to do more complex self-care tasks. I will be doing other their things with them. I will go to the ADL kitchen and we'll make brownies from box or from scratch or whatever. And then I will assess that. Is that person safe to go home and do their own self-care and manage their medications and even maybe perhaps return to driving again? But there's so much you can tell from a person by the way they do a cram. What is this bringing bringing out for you.

[58:55] Oh, no, I just like hearing what you're saying. I mean, it's definitely true, though, and I think it does connect back to some of what I was talking about with translating, the activities, the outside activities to learning in the classroom, because I think the students could actually figure out in some ways what works best for them in learning if they're doing something that's fun, and then they realize, oh, if I do this, maybe I can also use that in my classroom activities because it worked for me here. I think this has been fabulous. Thank you so much to both of you for doing this and for being willing to share your expertise with the podcast listeners. I really appreciate it. And you know, you guys both know how much I, I hope you both know how much I love you and I'm grateful for you. So thank you so much. Very mutual. Yeah. They're very mutual.

[59:53] Well, darling spinner, that's it for me this time. Next week, I will be back with an episode, the first of a series of episodes on fiber, and we're going to be focusing on fiber blends. So while you are waiting for the next episode, be sure to spend some time spinning something. You know it will do you good.