Feeling Well: Using the Augmented Touch of E-Textiles to Embody Emotion and Environment as a “Self-Health” Intervention for Female Student Wellbeing

Abstract

COVID-19 led to unprecedented levels of isolation for students, and the withdrawal of social support mechanisms left them detached from their networks. This significantly affected their mental health, with more female than male students reporting increased anxiety. Unparalleled restrictions in accessing outdoor environments led to a sense of nature-deficit which further compounded their stress. As learning off-campus becomes the new social norm, students are seeking alternative ways to self-support their emotional wellbeing. This paper explores how students can take a “self-health” approach by drawing upon the restorative powers of nature as a coping mechanism. It considers individuals’ relationships between their personal environments and somatosensory experiences through the medium of e-textiles. The research is underpinned by Attention Restoration Theory and Stress Reduction Theory. Utilising a bricolage methodology it extends the author’s previous research in this field and explores these theories through textile-led, practice-based research. It describes the design of 3 crafted e-textile concepts to explore alternative approaches to self-managing student mental wellbeing. The concepts investigated ways that students could connect virtually with nature through e-textiles using affective touch and haptic-mnemonics to embody natural environments. The textiles sensed physiological biomarkers related to un-noticed stress and created augmented cues which triggered felt experiences and tactile memories. These moderated the biomarkers and educed a sense of calm. The concepts demonstrated the potential to integrate with everyday clothing and create opportunities for students to enhance awareness and management of their mental wellbeing. The mixed-methods research was evaluated through a focus group. The results affirmed that the concepts had technology and social value and were effective in moderating stress by creating place-attachment. The paper concludes that commingling opportunities for visual, virtual and embodied feedback through augmented and affective touch creates a “somato-haptic nexus” which offers a complementary model of early intervention for self-supported student wellbeing.

KEYWORDS:

• E-textiles
• embodied emotion
• embodied environment
• haptic mnemonics
• tactile memories
• student wellbeing

Introduction

Wellbeing is generally regarded as a concept which is fundamental to the definition of health. The World Health Organisation (WHO) describe mental health and wellbeing “as one’s ability to cope with the stress of life, realise their potential, learn well and make positive contributions to society” (WHO 2022). Stress, anxiety, and depression are inter-related, affective states and the array of emotional responses are indicative of one’s mental state at a given moment in time. Creating positive states of mental wellbeing relies on many factors, including physical human-to-human connection (Von Mohr et al. 2021) and human-to-nature connection (Hartig et al. 2014). These have long been recognised as valuable components for maintaining personal mental wellbeing. However, the increased pace of living and the intrusion of technology to almost every aspect of daily living has caused social distraction. This often reduces opportunities for physical connections and replaces them with virtual connections as technology increasingly mediates social interaction. Adolescents and young adults have been exposed to technology and social media from an early age and are especially affected. The reassurance of a welcome touch has been replaced with social media “likes”. The overuse of mobile phones has also been linked to reduced human-nature interactions (Wang et al. 2021) and the cumulative effect impacts adversely on psychological wellbeing. The withdrawal of human connection or experiences of even small social exclusions are known to have negative psychological and physiological effects on human beings (Williams 2009). The profound consequences of social disconnect result in chronic physical and mental ill-health and have been linked to increased mortality (Hawkley and Cacioppo 2010). The mental health of young people (aged 10-24) who are particularly susceptible to the negative effects of social isolation were significantly affected by the social restrictions imposed during COVID-19 (Organisation for Economic Co-operation and Development 2021). The long-term effects of social deprivation caused by COVID-19 are still unclear but may well affect society over a longitudinal period of time (Orben et al. 2020). New studies and interventions are needed to support society, with a focus on susceptible groups such as student populations. This research focused on a female student demographic and explored an embodied-emotion intervention using technology-augmented textiles.

Mental Wellbeing and Students – Causes and Coping Mechanisms

COVID-19 simply compounded existing mental health issues for university students, who were already known to be a high-risk group for quite some time (Kessler et al. 2005). The Student Mental Health Survey 2020 (Pereira et al. 2020) revealed that one in four students reported a mental health condition in 2019. It further noted that with the current level of support resources at universities female students in particular appeared to be at further risk of deterioration in their mental health. Students’ needs are individualistic and often complex and there is a well-established body of evidence showing that female and male students react differently to stress (Misra and Castillo 2004; Saravanan and Wilks 2014; Hitches et al. 2022). Recent surveys on stress during COVID-19 found that females’ reactions to stress during the pandemic were more acute than males (Olaseni et al. 2020; Visser and Law-van Wyk 2021) and a new UK mental health survey of university students during COVID-19, found that female students were more affected by depression and anxiety than their male counterparts (Chen and Lucock 2022). Transition to university life and self-management skills can already be challenging for all students to navigate. Financial pressures (McCloud and Bann 2019); cuts in university funding and socio-economic challenges brought about by widening access, student workload, exam pressure (Thompson et al. 2022), long waiting lists and finite support resources compound mental wellbeing issues (Docherty and Thornicroft 2015). Alongside this, it is estimated that almost half of university students choose not to reveal their mental conditions to universities (Thorley 2017) due to fear of stigmatism (Matteo and You 2012). Students often lack confidence to speak out about their issues or to trust the confidentiality of university support mechanisms. Without accessing appropriate support channels students can become stressed and anxious which can also negatively impact on their academic performance (Chapell et al. 2005). There is a need for alternative, self-managed approaches where students can take early action and control over their own wellbeing. Coping strategies for managing stress can be problem-focussed addressing the causes of stress, or emotion-focussed which responds to the negative emotions caused by stress (Stanisławski 2019). The research presented in this paper is directed at emotion-focussed interventions.

The Role of Touch in Wellbeing

Touch plays a vital role in stress management (Morrison 2016b; Rosamond et al. 2023). It is the primary language of compassion (Hertenstein et al. 2009) and its haptic perception offers a powerful, non-verbal mode of communication. A touch to the arm of another human can signify sympathy in a moment of grief, reinforce empathy or reaffirm affection for another. Even imagined touch can play a positive role in stress relief (Jakubiak and Feeney 2016). Touch acquires an affective value proportional to how it is received and how it matches the expectation of its recipient (Sailer and Leknes 2022). Personal factors related to the toucher, the receiver and the environment in which the touch is experienced are also important determinants of value.

(i) Physical Touch and Emotional Processing

The physiological effects of touch have been linked to increasing oxytocin levels, reducing blood pressure and lowering heart rate (Field 2010). It has a role in regulating cortisol production and heart rate responses, which are important for managing stress (Reinhardt et al. 2012; Pulopulos et al. 2020). Nerve receptors present on the skin called C-tactile (CT) afferents respond to gentle stimulation such a stroke, brush or light touch. The CT system makes neurophysiological connections attached to emotional and social communication, such as arousal (Tabbert et al. 2006) and comforting caress (Olausson et al. 2010). Affective social touch enables tactile and emotional processing and is in this sense an important buffer to stress (Morrison 2016a). It is useful in combatting isolation and loneliness, which negatively impacts mental health, and is helpful in promoting psychological wellbeing (Steptoe et al. 2013). Affective touch is an important element in somatics, which is an individual’s physical perception of how the body perceives itself from within (Hanna 1986). The somatosensory system provides a neural pathway system between the brain and body, and is responsible for processing information about feelings experienced within the body. Information received from the body to the brain can determine crude touch such as pain, or fine touch such as vibration, proprioception and 2-point discrimination such as gentle stroking.

(ii) Textiles, Gestures and Playfulness in Wellbeing

Textiles invite human touch. Their inherent qualities of texture and form encourage gestures which extend beyond handling to become part of the emotional experience for the person interacting with them (Petreca et al. 2013). Gestures can reveal how one feels or expects to feel, whether consciously or subconsciously and impacts sensory feedback, emotion, and cognition (Waldman-Levi et al. 2015; Treadaway et al. 2019; Farley et al. 2021). Hand gestures can reveal signs of stress or be employed as a coping mechanism (Vohs and Baumeister 2016). Wringing hands, squeezing fists, fiddling, and fidgeting can occur in response to a stressor. Left unchecked, these acts become an amplified and negative display of anxiety and may exacerbate existing stress. Channelled positively, they may act as a self-soothing experience and some studies have shown that purposeful activities involving the hands, can boost positive thinking and lift depression (Sadlo 2011; Treadaway and Kenning 2015). Fidgeting can positively support wellbeing and combat stress (Alonso et al. 2008; Karlesky and Isbister 2016; Ridenhour 2017). The repetitive nature of fidgeting with self-selected objects is thought to release a natural stimulant in the brain (Mason et al. 2007; Bremner and Rodgers 2013). Clothing is an obvious choice as a close-at-hand medium for stress relief and individuals often sub-consciously play with clothing, squeezing cuffs, pulling zips up and down or fastening and undoing buttons.

Spontaneous playfulness, fun, and laughter can also bring significant wellbeing benefits to individuals (Waldman-Levi et al. 2015; Farley et al. 2021). Engaging in playful activities reduces stress in adolescents (Staempfli 2007) and have been shown to be important coping mechanisms for stressed university students (Qian and Yarnal 2011). Fiddling and fidgeting with clothing is also associated with playfulness and existing studies have shown how this can help to calm and comfort those with dementia who often instinctively twiddle with their clothing (Stephens et al. 2013). Handling artefacts such as textiles can bring about feelings of positivity, leading to a sensation of calmness which decreases anxiety (Morse et al. 2016). Playfulness in handling objects with different textures can be a useful distraction to stress and shares many commonalities with coping mechanisms. Both are self-initiated, require active-engagement, persistence, creativity and multi-strategy approaches (Saunders 2012) which may partly explain the true value of playfulness in stress management.

(iii) Augmented Touch of E-Textiles and Wellbeing

Textile designers have a lexicon called “textile hand” (Ciesielska-Wrobel and Van Langenhove 2012) to describe the physical sensations and reactions experienced from interacting with textiles. Although the experience of touch occurs through physical handle, textiles also have the ability to embody individuals’ emotions (Dolan and Holloway 2016). The associated felt experiences (Essick et al. 2010) convey meaning (Etzi et al. 2014) and acquire an affective value through a combination of physical touch, and emotional embodiment derived from neuro-based attachment to place and memory. The auditory, visual feedback and tactile experiences felt through this interaction (Atkinson et al. 2013) can be further augmented through wearable textiles which can provide a sensory metaphor for amplifying emotion. For example, auditory feedback experienced through textile speakers, visual through LEDs, and tactility felt through haptic vibration. E-textiles and clothing has the advantage of intensifying the benefits of fidgeting by embedding visual or haptic feedback into the textile to create somatosensory experiences for wearers (Craig and Rollman 1999). The amplified sensations can contribute to moderating their anxiety. The value of e-textiles in supporting emotional wellbeing has been recognised and recent studies suggest its usefulness in combatting loneliness (Nevay 2021); visual impairment (Giles 2021); healthy ageing (Yang et al. 2019); rehabilitation (Elo et al. 2022) and dementia (Robertson et al. 2020). However, there are very few studies linking e-textiles and wellbeing with the environment.

The Role of the Natural Environment in Stress Reduction

(i) Stress Reduction Theories

Stress Reduction Theory (SRT) (Ulrich et al. 1991) postulates that being present in non-threatening, natural environments such as green or blue (water) spaces reduces the psychological and psychophysiological effects of stress. Exposure to natural environments are thought to reduce cortisol (Beil and Hanes 2013), lower heart rate (Annerstedt et al. 2013) and decrease blood pressure (Li 2010). Attention Restoration Theory ART (Berman et al. 2008) is closely related to SRT. It propounds that interacting with nature enhances cognitive capability through involuntary attention captured by noticeable stimuli of the environment, and voluntary attention, which is actioned by deliberate, cognitive control. Introducing natural elements to urban, open spaces are also thought to bring about positive cognitive benefits (Nikkhou and Tezer 2020). The often-un-registered connection that exists between humans’ mental wellbeing and their natural world (Roszak 2001) can be explained through Biophilia Hypothesis (Kellert and Wilson 1993). This contends that human beings have an innate love for the natural world and seek opportunities to connect and immerse themselves in nature, enabling them to react emotionally to specific stimuli such as sitting by a river, climbing a mountain or walking through a forest park to alleviate stress.

(ii) Nature Deficit Disorder (NDD)

The desire to connect with nature and the environment is heightened in times of significant psychological distress caused by social disconnect (Poon et al. 2015; Ryan and Deci 2019). This detachment was felt on a global scale when COVID-19 brought unprecedented and radical socio-cultural changes that caused immediate cessation of opportunities to connect with friends and the environment. Opportunities for physical touch became limited during COVID-19 which had a profound effect on mental wellbeing. Students were one of the most affected demographics. Being cooped up in student accommodation, the instant withdrawal of in-person studying and a loss of social contact in situations where many were already displaced from their own localities compounded their distress. Not being able to avail of usual self-help wellbeing strategies such as visiting parks and country-walking further exacerbated the situation and resulted in a sense of nature deficit. The phenomenon of Nature Deficit Disorder (NDD) (Louv 2008) associates a lack of interaction with nature with a significant detrimental effect on wellbeing. It is recognised at present as a theory, rather than a medical condition. In his book Last Child in the Woods Louv (2008) suggests that a withdrawal from nature diminishes the use of the senses, causes attention difficulties and leads to higher rates of physical and emotional illness. He asserts that exposure to nature is an essential component for the physical and emotional health of both children and adults. His ideas around exposure to a natural environment as a means to creating a positive sense of place, reducing stress and promoting cognitive restoration are well supported by empirical evidence (Capaldi et al. 2017).

(iii) The Restorative Power of Nature

Interacting with nature has restorative benefits and has been shown to have positive cognitive effects on depression (Berman et al. 2008); enhance social relationships (Webster 2011) and can be an effective healthcare strategy (Bowler et al. 2010). Restorative natural environments are generally thought of as places to escape from the pressures of daily life or to rest the mind. Often these hold specific place-attachments (Ramkissoon et al. 2012) for individuals who identify with a particular environment and assign personal significance and value to it. This can heighten their sense of bonding with nature, resulting positively on their wellbeing (Kamitsis and Francis 2013). Environments with place-attachment could be community allotments which have been shown to improve mental and physical wellbeing through social connectedness or connecting through the gardens themselves (Bailey and Kingsley 2020). Re-visiting places associated with positive childhood experiences in natural settings can heighten sentimental memories and help recall feelings of emotional security (Windhorst and Williams 2015; Birch et al. 2020). Recent studies also suggest that students prefer to spend time in natural places that are familiar to them (Windhorst and Williams 2015) and there is a growing trend in students escaping the stimuli of the urban campus environment to immerse themselves in natural environments as a self-help wellbeing strategy (Puhakka 2021).

(iv) Virtual Restorative Environments

When immersing oneself in nature first-hand is not possible it has been shown that views of nature outside from a window can speed up healing processes in hospitals (Tennessen and Cimprich 1995; Bratman et al. 2012), or improve a student’s examination results (Li and Sullivan 2016). Some studies have shown that photos of natural environments can act as a surrogate for nature and have potential value in reducing stress (Ulrich et al. 1991; Kaplan 2001) and alleviating feelings of social isolation (Yang et al. 2019). Other studies have engaged participants in immersive technologies and computer-generated nature settings as a method of reducing stress (Valtchanov et al. 2010; Nukarinen et al. 2022; Ünal et al. 2022). Yomiuriland for example is an entertainment park in Tokyo which combines real flowers and state-of the-art projections of nature to create an immersive nature-walk-through experience.

(v) Nature, Wellbeing and E-Textiles

Smart textiles have the potential to regulate emotions positively (Uğur 2013) and the theme of nature is a well-established source of inspiration for fashion designers. However, there are only a few examples of designers combining textiles, emotion and nature. BIOdress (Adhitya et al. 2016) demonstrated a technology-enabled garment that communicated environmental data through an embodied experience. It inspired wearers to feel at one with nature and experience the environment from a non-anthropocentric perspective. Pleats actuated to expand at different speeds and emulate breathing in response to air quality, and fabric leaves controlled by an EMG sensor actuated them to flutter sympathetically. Wearable Forest (Kobayashi et al. 2009) was another example of a nature-inspired, e-fashion garment creating a sense of unity between wearers, nature and the urban environment. Its light-emitting, interactive dress was embedded with embroidered speakers to enable real-time sounds captured from a forest to be visualised in corresponding light patterns on the dress. The dress transmitted urban sounds back to the forest for a fully integrative, two-way interaction. “Climate Dress” (Diffus 2009) was a concept which sensed CO₂ levels and translated these into light-emitting patterns on the wearer’s dress to stimulate conversations and debate around environmental and pollution issues.

E-Textiles as a Support Strategy for Student Wellbeing

Drawing together themes discussed thus far of student mental wellbeing, the role of the natural environment and the benefits of affective touch, the remainder of the paper proposes a novel, approach to the self-management of student wellbeing through e-textiles. Humans are wrapped in textiles from the moment they are born to the moment they die. Clothing comes into contact with 90% of skin (Axisa et al. 2005) and skin can reveal a lot about a person’s health. Textiles offers a natural interface with the body, and e-textiles can capture miniscule signals discharged on the skin which reflect a person’s physiological or psychological state. Minute changes in skin conductance, temperature, or blood volume can be recognised on the skin and fluctuations can be caused by acute, fleeting or even unnoticed changes in emotional states through the phenomenon of somatics. This supports self-regulation by drawing upon the body-mind connection but is not always recognised by humans. Somatic awareness can be heightened when humans become more alert to kinaesthetic cues, which can positively transmute their physical state and help to moderate stress. E-textiles can offer a mediating system by amplifying embodied experiences by virtue of haptic, embedded technology. Textile sensors can detect body cues and activate haptics to augment bodily felt experiences. This can deepen a wearer’s understanding of their own emotions and body cues and enable them to take positive action to manage their stress. This may be particularly appealing to students who are reluctant for a myriad of reasons to ask for professional help and are seeking discreet ways of self-managing their stress.

Methodology

A bricolage methodology was used to configure the research. Bricolage recognises and responds to the inter-relationships between participant, researcher and the context of the environment and is a particularly useful research method in uncertain times (Robb 2020). This made it an appropriate methodology to select during COVID-19. Its reflexive approach enables researchers to intentionally mix qualitative approaches to research by using existing data and new data to create novel research. Figure 1 summarises the research framework. Stage 1 comprised three elements of data which informed the bricolage. Firstly, outcomes from student narratives and perceptions recorded at a previous participatory workshop group just prior to COVID-19 (Coulter et al. 2022) were further built upon. Secondly, online conversations and observations with students across the UK conducted during the COVID-19 lockdown period were considered. Thirdly, photographs of nature taken during periods of permitted access to parks during lockdown were drawn upon. The collated outcomes from Stage 1 informed the practice-based element which took place in Stage 2 of the research. This comprised three exploratory textile concepts in response to the themes raised by the students to address sub-conscious stress. Stage 3 evaluated early prototypes of the concepts through a focus group. The evaluation used Likert scales and supporting student narratives based on their views around social and technology acceptance.

Figure 1 Methodology framework.

Stage 1 – Bricolage

(i) Themes Collated from Previous Research

Outcomes from a student-focussed, participatory e-textiles workshop on the self-management of stress (Coulter et al. 2022) carried out by the author before lockdown were reviewed and collated into four themes. These comprised:

• The value of restorative environments

Students placed considerable value on ‘natural environments’ as ‘happy places’ and recorded how immersing themselves in these made them feel relaxed. They spoke about places that triggered happy memories and the feeling of a connection to nature and wellbeing in these environments. They offered examples particularly from childhood memories such as blowing dandelions, paddling in water and making daisy chains in the garden, and expressed concern that COVID-19 had taken away the opportunity to visit natural outdoor environments.

• Repetitive fidgeting as a stress indicator and coping mechanism

Subconscious behaviours of stress can be manifested and relieved through fidgeting and repetitive habits. Self-care and compassion for oneself can have a significantly positive effect on wellbeing (Raab 2014). However, students reported that they did not always recognise their stress or stressors. That being the case, research shows that students can often adopt unhealthy mechanisms of self-care (Kelley et al. 2017). During the participatory workshop the students demonstrated how they interacted with the textiles and gestures they were comfortable with. Most frequently mentioned was squeezing, fidgeting and fiddling with cuffs, lapels and drawstrings of garments they were wearing. This was intuitive and occurred when they were stressed or as a self-help response to stress. They talked of stroking textiles as a form of self-soothing. Their other narratives were around tapping on a textile in a sequential pattern as a stress relief; wringing hands and undoing and re-doing straps repeatedly. The students comments related to the repetition of engagement either subconsciously or as a conscious effort to de-stress. They suggested that counting the frequency of repetitive fidgeting or squeezing could be both a factor in assessing cumulative stress or as a source of comfort to relieve stress.

• Understanding In-the-moment-stress

Students revealed they were only interested in managing stress that they were experiencing at a given moment in time and that recognising patterns of their stress over time, or reflecting upon it was not a high priority for them. They remarked that they did not perceive any value in looking back at something that they could not change, and described wanting “there-and-then” and “instant relief” solutions to their “in-the-moment” stress.

• Need for ease of feedback

Students perceived that commercially available health apps and trackers were more likely to be aimed at physical fitness and questioned why designers of wearables appeared to attach more value to health associated with fitness rather than with mental wellbeing. They reiterated the need for any intervention to be effort-free to fit in easily with daily lifestyles. One student said that her preference was for information to “come to her, without logging into an app”. Other students suggested that they either felt “stressed or didn’t” and that there was no need for incremental, numerical or complex data and simple analog “on or off” feedback would suffice to indicate stress.

(ii) Place-Based Attachment to Nature during Lockdown

Online teaching brought about suddenly by COVID-19 changed the dynamics of academic-student engagement. Remote conversations offered a social point of contact for isolated students during COVID-19 and presented academics for the first time with a “window” into the private environments of students. During the author’s online internal and external engagements with students across the UK as part of teaching, external validation and examining duties common themes emerged of student isolation, lack of social contact, and loss of connection to environments of comfort had exacerbated their stress. The students’ anecdotes revealed that confinement to urban-based campuses and restrictions on travelling to parks and other natural environments had negatively impacted upon their mental wellbeing. Their narratives confirmed existing research which contends that when place-attachment from one’s significant place is disrupted, the negative impacts on wellbeing are substantial (Scannell and Gifford 2017). During the same period the author had collected nature photographs taken during permitted lockdown walks. Taking advantage of serendipitous opportunities to connect personal and environmental dynamics can enhance the diversity of information collected (Reviglio 2019) and offer a rich resource to add unexpected value to research (Björneborn 2017).

Outcomes of Stage 1 Bricolage

The bricolage of data collated in Stage 1 was drawn together to consider three types of feedback that support emotional processing.

Firstly, recognising the significant potential that touch and textile tactility has to elicit emotional feedback. Texture and handle of materials next to the skin can contribute to reducing stress and encourage positive emotions (Treadaway and Kenning 2015). Students in the participatory workshop had described how they handled fabrics and noted that they fidgeted and stroked fabrics in different contexts as both an indicator of their stress or as a self-soothing strategy.

Secondly, the importance of visual feedback afforded by the natural environment was recognised. The author’s photographs and student ad-hoc, online conversations highlighted the value of nature, the importance of place-based attachment and the effect that withdrawing access to nature had on students’ mental wellbeing. Visual feedback received from time spent in natural environments can improve mood and support good mental health (Kotera et al. 2021). Some studies have demonstrated this as a particularly useful strategy for improving the wellbeing of university students (Song et al. 2018; Zhang and Ye 2022). Showing visual imagery of nature to students has also been shown to reduce their symptoms of anxiety (Pile et al. 2021; Browning et al. 2023). Even envisioning imagery in one’s mind of being immersed in nature can aid mental clarity (Hänsel and von Känel 2013), reduce stress, and create a sense of calmness (Owens and Bunce 2022).

Thirdly, the bricolage brought to the fore the potential for embodied feedback. One of the themes from the participatory workshop related students experiencing “in-the-moment” stress and the intuitive feelings that this educed alongside a desire for an “instant remedy”. The phenomenon of “embodied cognition” contends that the body is “knowing” of the mind and both are interconnected in experiencing stress. Ruminating on negative thoughts can manifest as physical sickness or emotional distress invoking inexplicable feelings in the stomach or felt on the skin. Conversely, drawing positively upon imagination may enable beneficial somatic experiences. Stage 1 positioned Stage 2 of the research which enabled an exploration of ways to harness tactile, visual and embodied feedback in e-textiles. This was used as a starting point to investigate how some or all of these feedback elements could bring a holistic approach to exploring how female students might recognise and positively respond to stress and support their own wellbeing.

Stage 2 – Practice-Based Research

In contemplating how students might see, feel and be calmed by nature when natural environments were not accessible to them, the photographs taken in lockdown were used for inspiration. They were loosely clustered into recurring, linear patterns in nature and considered in a textile context (Figure 2a–c).

Figure 2 Haptic schematics inspired by patterns in nature: (a) concentric; (b) spiral; (c) ripple.

1. ripples on a pond as concentric circles

2. spirals as shape and movement

3. water running by a river as wavy lines

The overarching idea was to see if the extended properties of an e-textiles artifact could connect envisioned and embodied environments to regulate emotion. Embodied emotion (Pernau 2014) plays a critical role in managing stress. Sensing one’s bodily feedback can be a catalyst for moderating self-perception of mental wellbeing and changing individuals’ acuities about themselves or their bodies (Radziun and Ehrsson 2018; Tajadura-Jiménez et al. 2018). Being present in the natural environment can be a restorative experience (Kaplan 2001; Pearson and Craig 2014) and promote positive mental health. However immersing oneself in nature is not always convenient or practical. The practice-based elements of the research proposed a response to these issues through e-textiles. Their augmented properties were incorporated into technology-enhanced accessories to evoke “happy place” memories and stimulate interplay between body and mind through affective touch.

The author proposed a “Somato-Haptic Nexus (Figure 3). This novel model considered how the visual prompts of pattern and tactile elements of textiles could be augmented with haptic mnemonics, to trigger tactile memories related to positive environments, bring an awareness to stress and create self-management opportunities.

Figure 3 Multi-sensory feedback mediated through e-textiles.

Haptics are electronically generated vibrations felt in the body. Mnemonics are an aide memoire strategy. A “haptic-mnemonic” was created by arranging vibrating motors in patterns inspired by nature. These acted as reminders to evoke memories of happy times spent in nature environments. Increased stress was sensed through a textile sensor and when a threshold stress level was detected the augmented cue activated the haptic patterns. This triggered the positive memory and encouraged the wearer to re-anchor and calm. The bio-feedback in the sensor detected lowered stress and deactivated the haptics and indicated a calmer emotional state. This somato-haptic nexus model was used as the starting point for the textile concepts designed by the author.

Concept 1 – Haptic Dandelion

Concept 1 was inspired by students discussions of happy childhood memories blowing dandelions and the metaphoric association they attached to this of blowing away stress. The “Haptic Dandelion” concept illustrated how memories and nature can be connected to wellbeing through somatosensory experiences. It sought to mimic a dandelion in the wind through visual imagery and embodied sensation. Textile patterns inspired by photographs of dandelions taken during lockdown walks (Figure 4a) were digitally printed (Figure 4b) and tested on various fabric weights (linen, wool and silk) (Figure 4c). The underside of the cloth mapped mini vibrating motors in a spiral arrangement to the printed dandelion patterns on the topside of the cloth. A textile sensor was made and stitched to the cloth. It was positioned where it could be easily touched. The sensor captured elevated skin conductance which signals minute electrical changes on the skin of the forefingers and is associated with signs of stress. When the textile sensor reached a pre-determined level of stress, mini vibrating motors were programmed using an Adafruit Playground to actuate sequentially. This created a kinetic sensation against the wearers skin of the spiral growing bigger to mimic the stress blowing away. Figure 4d illustrates the schematic design of the spiral haptic. It was anticipated that future iterations would see the e-textile panel be integrated into a close fitting garment where the somatosensory experience could be most acutely felt.

Figure 4 (a–d) Design process for Haptic Dandelion.

Concept 2 – Repeating Patterns

Repeating Patterns picked up on the theme of repetitive fidgeting as an indicator of stress.

A student anecdote collated from the Stage 1 Participatory workshop recounted how when she was stressed she would repeatedly trace and retrace her fingers around the textile patterns of old chairs without thinking. Another student at the workshop asked “could the frequency of use of a wearable track individual stress?” These conversations inspired Concept 2. Figure 5a shows how ripple patterns were extracted from a photo of moving water. A textile-tufted, stroke sensor was created in a ring shape to reflect a concentric ripple pattern and create fidget appeal. Some of the tufts were made from conductive thread and as a finger instinctively fidgeted with the texture and re-traced the loop a count of +1 was added to the circuit. Each revolution recorded the frequency of their fidgeting as an indicator of stress. Figure 5b illustrates the sensor schematic. Different textile constructions were also tested. For example Figure 5c shows a free-machined embroidery version of the sensor on a silk velvet cloth base. The most successful version was created using a linen cloth as a base with a needle-punched texture of heavy cotton thread and conductive thread (Figure 5d). The cloth was stable enough to support the microprocessor stitched to it and open-weave enough to enable the thicker threads to be easily pass through the cloth. The sensor was programmed with an Adafruit microprocessor and when a threshold of 10 fidgeting revolutions was reached mini vibrating motors mapped to the linear water ripple patterns were activated sequentially to mimic moving water. Figure 5e illustrates the schematic for the haptic textile actuator and Figure 5f shows the underside of the textile prototype.

Figure 5 (a–f) Repeating Patterns concept development.

Concept 3 – Pulse-a-Daisy

The Pulse-a-Daisy concept was also inspired by student narratives captured during Workshop 1. One student relayed a childhood memory of sitting on the grass and making daisy chains. A prototype was developed as a crocheted scarf based on this memory. The daisy chains were visually represented by interconnected crocheted relief patterns which resembled daisies and were embellished on to a hand knitted scarf. The concept was further interpreted as a metaphoric chain reaction for stress. It differed from the other samples in that the feedback was light rather than haptics. This offered an opportunity to compare student perceptions about different types of feedback embedded into e-textiles. Touching a daisy at one end of the scarf sensed levels of stress. Conductive traces knitted into the structure of the scarf connected the sensor to the actuator at the other end of the scarf. The sensor used an optical technique called photoplethysmogram. As a green light beside the sensor was touched it illuminated the skin and measured the changes in blood volume as the red blood absorbed the green light (Barela 2019). A miniature crocheted pompom hanging from the scarf acted as a soft switch that activated the circuit when squeezed (Figure 6a). This ensured that the sensor was only active when the wearer intended measuring her stress. It was programmed using a small microcontroller embedded in another of the daisies. Data was outputted by a micro-LED embedded in another crocheted daisy at the opposite end of the scarf (Figure 6b). Pulsing light known as wave modulation (PWM) was mapped to the wearers breathing rate. This enabled the wearer to discreetly check her heart rate in times of stress. Rapid breathing is associated with increased heart rate and stress, and any quick pulsating light from the crocheted daisy alerted the wearer to elevated levels of stress. By actively focusing on slowing breathing down the wearer could receive positive physiological feedback in the form of slower pulsing light which corresponded with her new calmer state. The daisy chain acted as a visual cue associated of time spent in nature to focus on. Figure 6c shows the finished scarf and Figure 6d shows it being demonstrated at the focus group.

Figure 6 (a–d) Concept development of Pulse-a-Daisy scarf.

Stage 3 – Evaluation

The concepts were evaluated at a focus group workshop. Full ethical approval for the research was obtained prior to the workshop. Research suggests that between five and ten participants are an ideal number for a focus group (Krueger and Casey 2014). Eight female students aged between 21 and 25 were recruited using a convenience sampling method (Jager et al. 2017). 6 students ultimately attended the workshop. The method was chosen as this stage of the research took place in the second COVID-19 lockdown when there were restrictions on social integration. All of the student participants were flatmates and considered as “one bubble” and able to mix which enabled the research to proceed. Social distancing guidelines were adhered to and reasonable precautions were taken in line with Government guidance at the time. The students who participated voluntarily responded to an email invite confirming their interest, household status and consent to be filmed. During the focus group students were encouraged to interact with the samples and observations about how they touched the textiles were videoed. They were asked to evaluate each concept using a template adapted from the Mental Health Evaluation Recovery Star (McKeith et al. 2010; Briggs-Goode et al. 2016). Each leg of the starfish template had a Likert scale which related to 5 elements associated with the Technology Acceptance Model (Davis 1989) – (i) Social Acceptance; (ii) Technology Acceptance; (iii) Ease of Use; (iv) Usefulness and (v) Aesthetics. There was also a section for students to expand upon with personal narratives. Every participant completed starfish score sheet for each concept. Their scores were assigned a coloured-coded line and mapped to a master Starfish Likert Scale. The average of all scores was visualised through a shaded pentagon overlaid on to the Starfish template. This format made it easy to compare data across concepts. Figure 7 shows how the scores were visually compared to each other and Table 1 provides a summary of scores with cumulative averages for all of the elements evaluated for each concept. These averages ranged between 74% and 89% suggesting that the idea of using e-textiles as a discreet, self-managed intervention was acceptable to students.

Figure 7 Comparison of concept scores visualised.

Table 1. The average scores across the themes evaluated.

	Haptic Dandelion	Repeating Patterns	Pulse-a- Daisy	Cumulative average for each element
Easy to use	90	93	85	89%
Useful	70	83	76	76%
Social	97	77	53	76%
Technology	80	80	62	74%
Aesthetics	97	73	53	74%
Cumulative average for each concept	87%	81%	66%

Haptic Dandelion scored highly across the five elements of technology acceptance with an overall average acceptance of 87%. The haptic technology was programmed to simulate kinetic patterns in nature and the feedback indicated that this offered an effective trigger with potential to connect wearers to their own preferred “happy place”. Students perceived that the concept would enable them to re-anchor and calm, if the imagery was customised to suit their preferences. Some participants suggested that they might pick imagery other than a dandelion. Their feedback narratives further illuminated their scores:

I think it is a good distraction to ‘think a better thought’ if you are stressed. I have a happy place and already try to use it when I am stressed but think the vibrations would greatly help.

I think this is useful, but unsure what my own pattern would be.

I think the haptic feedback would be useful. Very personal to you. Able to be used socially.

I could relate the feedback from this to my ‘Happy Place’.

The Repeating Patterns concept was well-received by the students and also scored highly across all five elements of the Starfish Likert Scale suggesting that it was a viable concept. In particular it scored 93% for ease of use and 83% for usefulness. This suggested that the tufted textile qualities were successful in creating a tactile opportunity to engage in the physical act of fidgeting to bring about relief and offer a “mental break” (Farley et al. 2021).

Pulse-a-Daisy was the lowest scoring concept, with a cumulative average of 66%. Students commented that they did not consider a scarf or hand-crocheted accessories fashionable or something that someone their age would typically wear. It differed from the other concepts as the output was light rather than haptics. At 53% the social acceptability was also considerably lower than the other concepts. This was attributed to the pulsing light, which the students felt would draw attention to their stress. Some did however express that they found the pulsing light quite entrancing and relaxing and would find this a useful aid in private settings to help them to slow their breathing down:

I would enjoy breathing with the light.

Like the idea of using it privately to try and slow down your breathing.

Like the idea of using it privately to try and slow down your breathing.

I would definitely use a tool like this to control my stress and heart rate.

Limitations

There were limitations to the research. The prints and designs on the concepts were for illustrative purposes based on comments from the Participatory Workshop in Stage 1 of the research. This imagery was not personal to the participants in the Focus Group at Stage 3 which may have limited how they connected their own memories to nature. Future studies could conduct further research to customise nature imagery for the targeted demographic.

Some of the hard components, particularly the heart monitor used in Pulse-a Daisy were flimsy and the connections broke easily as the scarf was handled. Also the conductive threads were not always reliable in completing the electrical circuits and it is clear that micro-components require further design refinement if they are to be effectively embedded into e-textile clothing.

The research took place during COVID-19 which restricted the size and format of the focus group and some participants had to withdraw from the study at short notice due to contracting COVID-19. A larger number of scores and narratives may have further validated the evaluation of the concepts. Nevertheless, the focus group had been preceded by participatory workshops and a previous questionnaire study which informed and validated this research. This study did however present an opportunity to hear first-hand accounts from female students about how they coped with isolation and their mental health during a global pandemic.

Discussion and Conclusion

To date the data on how e-textile wearables for emotional wellbeing are perceived and received in public is sparse and this research has been useful in bringing new insight to the field. The hermeneutic lens approach shone a light on female students’ thoughts around personal mental wellbeing and brought new understanding to the topic. Creating emotional experiences for individuals illustrated the potential for e-textiles to enhance personal awareness and encourage conscious connections between mind and body to support mental health.

Although the benefits of SRT and ART in using nature to reduce positive and calming emotions have been supported by empirical evidence, there has been little evidence to date to show how these theories might be applied in simulated environments or by utilising e-textiles. Inter-linking these contexts extended the theories and added new value to the research field. The textiles empowered individuals to refocus their attention to personalised metaphoric green and blue landscapes to support their recovery from mental fatigue. Drawing upon the power of restorative environments, the concepts elicited immediate, intuitive, and spontaneous emotional responses. This addressed “in-the-moment” stress by registering its presence and providing real-time feedback to individuals with little effort required from them. Students welcomed the simplicity of the feedback and the ease of use offered by the concepts which supported their preference for a self-managed solution.

The design outcomes brought new insight on how wearers wished to touch and handle e-textiles (input) as a method of gauging their stress and their personal preferences for recognising and managing it (output). They underscored the affective value and playfulness afforded by tactility of material to ensure that wearers remained emotionally invested with the textiles. In particular the concepts articulated the non-tangible aspects that e-textiles can bring to wellbeing and the notion of “inconspicuous wellness” as an important determinant of social acceptance. The research brought understanding to how and where students choose to manage or share their innermost feelings. The outcomes confirmed that the key to achieving social acceptability was to ensure that design remained subtle, no attention was drawn to wearers and information about their mental health could be shared with others which might compromise their privacy.

The novel concepts were early prototypes intended for encouraging provocative debate around self-embodiment through nature rather than finished articles. Their conceptual form considered how a wearer might become attuned with her body, understand self-care and take responsibility for managing personal wellbeing in everyday contexts. As more e-textile wearables are designed for integration into individuals’ lifestyles, acceptance of these soft interfaces to support emotional wellbeing in wider contexts may well become the social norm.

The research further confirmed that there was an appetite for self-monitoring emotional wellbeing in social environments. The findings offered suggestive evidence that self-perceptions of the body could be altered according to environmental and social situations using e-textiles as a catalyst. The concepts fulfilled students aspirations for what the author coins as a discreet “self-health” intervention which was socially and technologically acceptable, useful, easy to use, and which offered simple, unobtrusive feedback. The author’s “Somato-Haptic Nexus” provided a paradigm for wearers to engage virtually with their “happy” environment and evoke feelings of wellbeing. It brings new meaningfulness to textiles and offers a model for other researchers to develop and build upon in a range of wellbeing contexts and with other target demographics.

Additional information

Notes on contributors

Janet Coulter

Janet Coulter is a senior lecturer and researcher in fashion design at Ulster University. She holds a PhD in fashion technology, an MBA, an MSc in multimedia computer-based learning, and a postgraduate diploma in Higher Education. Her research interests centre around technology in fashion to support emotional wellbeing. Her collaborative and interdisciplinary research in fashion and textiles focus on digital technologies for the metaverse and bio-materials for sustainable fashion futures.

[email protected]