Therapeutic Knitting
By Betsan Corkhill
Knitters across the world say it's simply the best therapy, but why? Is there any substance to these claims? Betsan Corkhill of Stitchlinks takes a look...
Knitting forums are full of comments about the therapeutic benefits of knitting and we all know that knitting makes us feel good, but have you ever stopped to wonder why? As an ex senior physiotherapist the claims that some knitters were making intrigued me, so I decided to investigate further. What I've discovered is exciting and led to the birth of Stitchlinks.
At Stitchlinks we combine the therapeutic benefits of knitting with practical health information and support this with a secure, global friendship network. Research has shown that supportive friends help us to live longer, healthier, happier lives. Together this equips our members with a powerful tool enabling them to find balance in life and to manage a variety of long-term medical conditions.
Over the last three years I've been investigating hundreds of stories from knitters all over the world to explore whether they could have a medical or scientific explanation. Having justified them medically, I was intrigued to know whether the experiences you feel as you knit can be enhanced, learned and then transferred to other areas of life. From here I've developed the process of therapeutic knitting.
Why knitting?
It's thought that stress can cause or exacerbate up to 90% of medical conditions. Up to one in three of us will suffer from depression at some stage in our life. 7.8 million people in the UK live with chronic pain - only 14% of those ever get to see a pain specialist. So there is an urgent need to find an effective, easily accessible self help tool, not just here in the UK, but throughout the world. It's my belief that knitting can be one of those tools, so what is it that makes knitting different and how can something so simple fill that need...?
It's already known and accepted within the medical profession that occupied people feel less pain and depression, so that's a good start. However, the large amount of anecdotal evidence suggests that knitting has much more to offer. It isn't simply about keeping people occupied with an activity they enjoy. It's not just 'old fashioned' occupational therapy either. There's a lot more to knitting than initially meets the eye!
The rhythmic repetitive movements of knitting are important - quite how, we're not absolutely certain of yet, but we have our theories. Anecdotal evidence strongly suggests that they induce a form of meditation very similar to Mindfulness. Recent research has shown that Mindfulness can be very effective in treating depression and chronic pain. It can also help those who are fit and healthy to combat stress and to manage life's downs. It helps you to put into perspective any traumatic issues that would normally dominate your waking thoughts helping you to find a stable balance between problematic events and feelings and more positive, pleasant sensations within the current moment. It's a state of mind where you're not mulling over the past or fretting about the future.
Research done by Professor Richard Davidson of Wisconsin University has shown that practising just eight weeks of daily Mindfulness can have a positive effect on brain function and even strengthen the immune system. Dr Herbert Benson, Director of the Institute for Mind, Body Medicine at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School has carried out many clinical trials involving Mindfulness and has found that it can evoke the relaxation response to bring down blood pressure, heart rate and help to prevent stress related illnesses. He's even found that it can improve fertility and mentions knitting as one of the activities capable of evoking the relaxation response.
Mindfulness can be a difficult technique to teach, particularly to those who need it the most - the highly stressed, those suffering chronic pain or depression. These conditions make it difficult to concentrate the mind. Knitting is exciting because it opens up the benefits of Mindfulness to everyone, including children and those with learning disabilities. I believe it can give everyone a valuable self help tool to manage life's normal downs, plus a range of medical conditions to significantly improve quality of life and wellbeing.
Rhythmical repetitive movements are interesting in another respect. Research by Dr Barry Jacobs of Princetown University in the States has found that repetitive movements in animals enhance the release of serotonin. Serotonin levels are low in depression, it's an analgesic, it's calming and low levels of it decrease pain thresholds. So it could be that the repetitive movement of knitting is causing the release of this chemical and could explain why knitters feel less pain, feel calm and report improved mood.
In the rhythm
The rhythm of these movements has a calming effect which is already being used successfully to manage disruptive behaviour and ADHD in children. Many who have written to me say they use their knitting to manage anxiety, panic attacks, phobias and conditions such as asthma, where calmness is important. Of course the portability of knitting means you can carry your calming remedy around and use it when and wherever you need. This portability makes knitting, along with some needlework projects, unique in the craft world.
The automaticity of knitting is important, too. It occupies some areas of your brain, whilst freeing up others. Many find that this enables them to 'zone out' to become 'mindless'. This gives your mind a mini break from any problems, enabling you to escape into the sanctuary of a quiet mind. This brings down stress levels and breaks into negative or ruminating downward thought cycles.
This occupying of the brain at one level has interesting results if you're knitting in groups. Conversations can become more intimate more quickly and, as a result, communication improves. It's as if the brain is unable to think too critically or prejudicially about what it's saying because it's occupied elsewhere - it enables barriers to come down.
The action of knitting slows down thought processes, which is important in our modern, stressful world. Thoughts can often whiz around in our heads preventing sleep and keeping stress levels high. Slowing them down enables us to view, sort and process them. This could have important implications for those suffering from Post Traumatic Stress (PTS). Indeed knitters tell me their knitting significantly improves their PTS and in some cases cures it completely. This links in with research done at University College London by psychologist Dr Emily Holmes in 2002. She found that if a person performed a repetitive visuo spatial task during a traumatic event they experienced significantly fewer flashbacks. The report recommends looking at knitting and worry beads further.
Let's stay on the subject of PTS for a while and look at a treatment called Eye Movement Desensitisation and Reprocessing. It is a somewhat controversial technique used by some therapists to treat PTS and Schizophrenia. At a basic level clients are asked to follow the sideways movements of the therapist's finger whilst talking about stressful events. This somehow enables PTS sufferers to process their recurring thoughts - to file them away. Eye movements have been found to lower arousal levels and a lot takes place when knitting so there could be links to this therapy as well. Recent research by Dr Andrew Parker at Manchester Metropolitan University have showed that moving your eyes from side to side for 30 seconds every day can boost memory by 10%.
A constructive addiction
I believe the mild addictiveness of knitting is important because it enables it to take the place of other addictions. Many knitters use their craft to lose weight, prevent binge eating, to stop smoking, conquer alcohol cravings and prevent self harm. It can also improve the constant checking and rechecking symptoms of Obsessive Compulsive Disorder. Sufferers are replacing a destructive addiction with a constructive, beneficial one and this makes breaking the link with their addiction and the transition back to normal life much easier. Knitting also occupies the mind and hands which is an important aspect as it physically stops some addictions such as smoking.
Colour and texture are important influences on our lives, but science hasn't even begun to fathom them out, let alone clinically measure their affect on the human psyche. There's no doubt that colour and texture have an important affect on the lives of knitters. Simply looking at your stash and stroking it can make you feel happy. Those suffering from depression live in a world which is literally grey - depression desensitises people. The introduction of vibrant colour and texture can be the 'kick start' to their brains that begins the process of recovery. So knitting can help even before you pick up your needles!
When I first took my findings to psychologists at Cardiff University, one of the areas we chatted about was the Mind's Eye. I found it fascinating to discover that those who suffer from depression find it hard, even impossible to visualise a concept in their Mind's Eye. This led us to questioning whether knitting could reawaken this ability. After all you're referring backwards and forwards to a picture of the finished article and visualising the completed project in your imagination as you knit. It's an intriguing thought.
Of course the end product is important and although other activities and crafts have an end result too, the advantage that knitting has is that it can be achieved without requiring an iota of artistic talent and without mess or expensive tools. It can be done from an armchair or wheelchair without leaving home. This all makes knitting an ideal craft for all abilities and age groups in most situations - in hospitals, schools, workplaces and in bed if you have problems sleeping. It also cuts across class, culture, language and intelligence providing a universal tool that can be used as a key to motivating and improving quality of life and raising self esteem.
Many of those who send me their stories suffer from long-term medical conditions. They tell me that before discovering knitting they felt out of control of their lives and worthless in society. Often they'd wander through their days aimlessly, feeling isolated and lonely. The discovery of knitting changes all this. Suddenly they find they can do something and do it well, it gives them purpose and structure to life. They begin to plan forwards, set goals, self esteem rises and they begin to feel worthwhile in society again. The ability to give gifts and knit for charity increases self esteem further. Enforced rest periods become enjoyable - they're no longer seen as 'lazy'. Knitting enables them to regain their identity and enables them to feel special as individuals once more. Forgotten feelings such as excitement and anticipation are rekindled. These are emotions that can get drowned in the mire of chronic illness. Life becomes worth living again. Importantly they find they belong to a community of knitters. Feeling you belong somewhere is vital to wellbeing. You don't have to be ill to feel lonely or isolated. You can feel lonely surrounded by crowds as you commute to work - inner city life can be very isolating. Similarly mothers of young children can feel isolated as do many elderly - they can be isolated from society simply by not being able to negotiate their front door step!
Blocking pain
The apparent pain relieving properties of knitting were the most interesting to investigate. Many letters and emails have told me about how you can 'forget' pain when you knit. Even those suffering from severe pain say it's effective. These comments took me on a fascinating journey into the complex world of chronic pain. It lead me into trying to understand the intriguing relationship between the physical and cognitive aspects of chronic pain and how these interplay and intertwine to change the amount of pain you actually feel. Research has shown some fascinating facts about your brain and pain in recent years. The one that will probably surprise you the most is that pain doesn't originate in your muscles, joints or ligaments, but in your brain! Let me explain a bit more - the signals that travel up to your brain from an injured area do so as pain inducing signals. These have to be interpreted by your brain before you actually feel pain. Now comes the interesting bit. Researchers have also found that your brain can't concentrate on two things at the time. So if you occupy your brain with an activity that is absorbing enough to cancel out the pain signals, then your brain won't interpret those pain inducing signals. As a result you'll feel less pain and in some situations none at all! Knitting can quite literally take your mind off pain.
This process is called Distraction and can be effective for blocking out pain and other troubling thoughts. It can also help people to manage the feelings of nausea following chemotherapy. To add to this researchers have also found that signals passing down from your brain to an area of your spinal column called the Pain Gate can influence the opening/closing of this gateway. If it is open, all the pain inducing signals will pass. If it is partially closed, or closed, only some or none of the signals will pass. Your attitude and mood are significant in influencing this. So by making you feel good and raising mood your knitting could be helping you manage your pain in this way too!
Knitting enables people to experience relaxation. In a world where stress levels are high and prolonged many of us can forget what real relaxation feels like. You can be tense for so long that your body recognises this as 'normal' and you won't realise you need to relax until you experience it. Staff who work in Pain Management units tell me that it's difficult to teach those in pain to relax. Those who suffer from depression and anxiety have similar problems as do those of us with long working hours.
Regular relaxation is vital for bringing down destructive levels of stress hormones in your blood, but you need to be proactive in this - it won't just 'happen' by itself. The good news is that not only do you experience real relaxation whilst you knit (providing you knit with a good posture - see Stitchlinks guide to Posture), but you can learn what this 'feels' like and then 'remember' it. It is then possible to transfer or recall these feelings across to other areas of your life, for example before giving a presentation.
Holistic therapy
Knitting is an effective therapy because it deals with the mind and body as a whole. As such it is the perfect complement for all medical treatments. Having received hundreds of stories from knitters and stitchers across the world I've become fascinated with how and why some people manage to stay afloat no matter what life throws at them, whilst other sink under seemingly small pressures. I've concluded that the issues of loneliness/social isolation, self esteem, stress/anxiety, and an unoccupied mind that's left to ruminate on problems, are key. Knitting deals with all these issues. Traditional medical treatments tend to treat the body and not the mind, but research has shown that a person's attitude can be more important in how they manage their condition than the severity of the pain or illness they're suffering from. So surely it makes sense to treat the mind with at least equal priority.
Of course we mustn't forget amongst all this that knitting is also an effective hand exercise. It's used by many, not only to maintain movements and alleviate stiffness but to improve hand function, too. Combined with its pain relieving properties it's particularly useful.
Knitting can change negative thoughts and attitudes into positive ones. It encourages people to move forwards. Confidence, self esteem, motivation and mood improves. It gives people a vehicle by which to make social contact and, in so doing, keeps their world open.
Skills you learn whilst knitting can also be highly effective in education and industry. Forward thinking teachers are using knitting in classrooms and finding it facilitates learning, controls disruptive behaviour and is ideal for kinaesthetic learners. It also teaches patience and perseverance which is important in this world of instant gratification. The bilateral brain exercise can also help those suffering from dyslexia and dyspraxia. Anecdotal evidence suggests that not only does it help them to coordinate movements and thoughts, but it also slows down their thought processes to enable them to become more organised.
For those of us who are fit and healthy, knitting is an effective stress management tool that we can take into the workplace. And of course knitting in groups brings a whole different set of benefits, both in real face-to-face groups and those on the internet.
You can help
My research over the last three years has convinced me that therapeutic knitting could benefit everyone, but I need the help of as many knitters as I can muster to add to our body of anecdotal evidence. You can do this by filling out an online questionnaire on our Stitchlinks homepage at www.stitchlinks.com.
We're also looking to start up knitting groups in doctors' surgeries and hospitals. Our first one began in May 2007 at the Pain Management Unit of the Royal United Hospital in Bath and is very successful, so if you can help please get in touch or you can email me directly at betsan@stitchlinks.com
Article Copyright © Betsan Corkhill, 2007
