I always loved the cozy warmth of wearing scarves, the elegant way they frame the face and add some colorful flare, helping to complete a look by draping around the neck of a basic crew neck shirt. Luckily, I only needed to learn a basic knit stitch to start making my own scarves, back when I was a pre-teen Girl Scout. Lately, I’ve been drawn to yarn and the soothing, repetitive, time-consuming process of knitting. This time, rather than use needles or hooks, I wanted to try a totally tactile, sensory experience of hand-knitting. DIY chunky hand-knit blankets are actually very trendy right now, what with everyone hibernating for the winter months during pandemic times. Also, my step-sister made one, so of course I felt compelled to also make one. Start with tying a small loop, then continue to pull loops through the previous loops, otherwise known as a daisy chain. I found that this hand-knit stitch is completely comfortable and pain-free compared to using needles.
Hopefully, my clients would agree. Older adults with somatic symptom disorder may frequently experience pain or discomfort in various parts of the body, due to psychological distress, regardless of how pain free the hand-knitting process is. I’ve only met a couple older adults who seem to constantly have somatic complaints and I am not very familiar with the disorder, so I consulted the manual. Interestingly, “somatic symptom disorder may be underdiagnosed in older adults either because illness worry is considered ‘understandable’ in older adults who have more general medical illnesses and medications than do younger people” (American Psychiatric Association, 2013, p. 312). I think that hand-knitting scarves or blankets with a group of older adults should be done with the intention of sharing stories and prioritizing these unheard voices. The group format would promote socializing and support for each other, validating the real experience of their psychological symptoms. It is important to note also that “concurrent depressive disorder is common in older people who present with numerous somatic symptoms” (American Psychiatric Association, 2013, p. 312). With severe somatic symptom disorder, it becomes a prominent feature of the individuals identity and dominates their interpersonal relationships. While these older adults may have diminished quality in their relationships, they may have loved ones or a loved one in their past that they’d imagine knitting a blanket or a scarf for, as a gift. If they would like to knit an item for themselves, this is also a good opportunity to increase somatosensory awareness and reflect on their own lives. Hopefully, sharing stories about their lives in the groups helps to build a sense of identity other than just feeling pain all the time.
During this very soothing, rhythmic process I found I was easily able to tune in to sensory and body awareness, because of its simplicity. Blankets and scarves lend themselves to this because they’re a basic rectangular or square shape made up of straight rows. Without the extra work of decision making, using tools, or learning more than one skill, I was able to focus attention completely on self-care and noticing what my body needed. With a clear head, I easily attended to when I wanted to sit, when I needed to stretch, when I wanted to stand, or when I needed a hot cup of tea. The main goal for clients is eventually to understand how psychological distress contributes to their pain or discomfort rather than assuming something is physically injured or broken, which can be included as a psychoeducation discussion topic. For people who do have physical injury or limited mobility, this project is also helpful, because it could be done from a comfortable reclining position. Big, chunky yarn is not as challenging to use for older adults who may have poorer eyesight. Larger projects, like blankets may take many hours to complete and would require many group sessions. Clients should be encouraged to continue their work with others outside of a treatment group or on their own, as well.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
