I’m an #ActuallyAutistic #OccupationalTherapist & writer, and, frankly, I’m horrified by Sia’s movie Music. It’s exploitative, harmful, disrespectful misrepresentation and perpetuates ableist tropes. I’ve seen the prone restraint clip, and I want to talk about this. 1/18

Let me make this very clear: Prone restraint can be deadly and it is a violation of an individual’s autonomy. #ProneRestraintIsAssault. Using it under the guise of “It calms them down; they need the firm pressure” is a gross misunderstanding of sensory integration theory. 2/18

Deep pressure is a therapeutic tool for providing proprioceptive input in order to help calm a dysregulated nervous system. 3/18

Proprioception is one of our senses. It’s how we know where our bodies are in space, how much pressure is on our muscles and joints, where our different body parts are. You can think of it as your physical sense of self. 4/18

When we are having a meltdown or shutdown, our nervous systems are dysregulated, WAY out of balance. This is a physiological reaction. We feel scattered, out of sorts, like we’re falling apart. Deep pressure helps us put ourselves back together, so to speak. It grounds us. 5/18

Quick intro to the nervous system

Our autonomic nervous system regulates bodily functions such as breathing, heart rate, blood pressure, digestion. It’s divided into the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). 6/18

The sympathetic nervous system controls the fight or flight response, which is really fight, freeze, fawn, or flight. In a meltdown, our sympathetic system kicks into high gear. We go into fight, freeze, or flight. 7/18

The parasympathetic nervous system is your chill and relax system, also known as rest and digest. You can’t rest and digest if you feel unsafe. Normally there’s a balance between the SNS and PNS. This is called homeostasis. Our bodies feel best in this state. 8/18

Here’s where deep pressure comes in as a way to regulate the nervous system seized in meltdown. Deep pressure creates proprioceptive input, which activates the PNS & lets the SNS know it can relax. The danger is over. This is why a wanted hug feels soothing when we’re upset. 9/18

This is the physiological mechanism behind therapeutic weighted blankets, weighted vests, compression clothing to soothe anxiety & distress. It’s called sensory integration therapy. You need an occupational therapist to guide you b/c everyone’s sensory needs are different. 10/18

So, what’s the problem with Sia’s movie? It portrays a gross misunderstanding and misuse of sensory integration theory. Prone restraint is NOT therapeutic. Let me repeat this. It is assault, and it is deadly. Too many autistics have been killed this way. 11/18

But it’s providing deep pressure! Autistics in meltdown need this to calm down!
NO.
The key word is CONSENT. Deep pressure provided with consent is therapeutic. Without consent, it’s a violation and only makes things worse. It terrifies us into submission. NOT OKAY. 12/18

So what works? Co-regulation. You share your calm with the autistic in meltdown. When and how can you use deep pressure? When the autistic person consents and invites it! There’s something called bodily autonomy: the right to decide who touches us, when, and how. 13/18

Here are some examples of appropriate therapeutic proprioceptive input:
When my autistic kids where in meltdown, I asked them if they wanted a squeezy hug, a hand on the shoulder, or for me to keep them company without touching. If they choose the hug, that’s what works.14/18

I had a very weepy meltdown. My oldest teen brought out their weighted blanket, asked “Can I wrap this around you?” I nodded, and they wrapped that weighted blanket around me and sat quietly next to me, as I had done for them before. #AutisticEmpathy 15/18

With my husband, I will let him know when I need proprioceptive input and he covers my body with his until I feel grounded and calm. I’ve had friends do this for me too. ALWAYS WITH CONSENT!!! (This is not sexual, by the way.) 16/18

In my #OwnVoices romance novel with an #autistic protagonist, I have a scene where she has a massive meltdown & her best friend holds her close to him, asking “Is this okay”, & then carries her to her bed & covers her with his body, regulating pressure, until she calms down.17/18

Yes, I stole this scene from my life. I wanted to show autistic reality & supportive relationships. I’ll say it one more time: CONSENT! This is the difference between #OwnVoices media & harmful, exploitative media. (My book isn’t published yet, but it’s on its way.) 18/18

To clarify, the deep pressure I’m describing, the kind that helps me, an adult (and my character, also adult), is NOT prone restraint, or even restraint. I’m face up, in a supine position. In the film, Music is facing down when her sister restrains her. This can disrupt breathing

Now that I’ve read reports that these scenes haven’t been removed, I’m worried about the possibility that people will think it’s acceptable, or worse, necessary, to treat autistics this way. Did I mention prone restraint is illegal in many places?