What’s this “deep pressure” my Occupational Therapist always talks about? What’s does he/she mean?
Deep pressure is the deep touch (or tactile) pressure that results from stimulation of our tactile/touch receptors deep under our skin. Okay that’s easy enough. Touch the skin, and the receptors send the information to the brain in our tactile areas of the brain related to that given body part. Easy, right? oh no, it’s more exciting than that. This is perhaps one of my favorite topics to talk about as an occupational therapist. Think about it. Have you ever had a therapeutic/ spa massage that you didn’t like? Deep tactile pressure feels so good!!!!!! But why? Okay, here’s the exciting part………with a little bit of science/neurology talk.
When you are given a deep pressure touch to your body, in particular in areas that are typically in need of it, like your shoulders, back, or feet……the receptors send that information up a pathway in the spinal column called the Dorsal Column Medial Lemniscus, aka DCML (ahhh or ohhhmm)! It goes to parts of the brain that process that input at a nice pace, and goes to parts of the brain that give attributes/or learning concepts to it, such as textures/shapes, etc. Conversely, the light touch, hot/cold touch, pin prick touch goes to the Spinothalamic (ST) pathway to the frontal lobe (more primitive) and results in quick pull away motion or “fight or flight” response. Nothing is learned, it’s just a quick motion response to pull away.
This is why therapists always suggest deep pressure touch. Massage, or heavy work for patients/students. Deep massage, squishing or rolling resistive putty, getting squished under a pillow or blanket or with a beanbag chair, massage with lotion to the hands, wearing weighted lap pads, digging deep in beans or dried rice to find objects, etc. The science behind it exists. Have a child do something with deep pressure or heavy work prior to tasks to help with learning. As well, have your students that your OT has identified as tactile defensive do those deep pressure activities to help them deal with uncomfortable tactile input so that they can learn and develop through stimulation of the DCML.
You also, therefore, have to make sure that you avoid the opposing light or feather touch, or hot/cold touch. For these reasons, we suggest students/clients are never touched from behind, in other words, never give unexpected touch. If a child is learning to tolerate things such as hair brushing, give them a vibrating hair brush or heavy pressure massage to the scalp first. We suggest a deep pressure rub to the palms of hands with a surgical brush or massage to hands prior to touching textures that a student refuses to touch (paint, foods, etc). In these examples, we seek to stimulate the “good path” or the DCML. Um… Not the the Spinothalamic isn’t good…..we still need it to save our lives when we touch hot stove, or get a pin prick, etc. Both are important………..but stimulation to the DCML is very much needed!
As for myself, here’s my favorite way to stimulate the DCML besides a massage or pedicure……..snuggling/holding a 22 pound puppy on myself…..22 pounds of deep pressure……….instant relaxation. Notice we both benefit from it:) Don’t judge me for spooning my puppy:)
Mary L. Adolf, M.S., OTR/L