Well Being

July 29th, 2011 8:50am - Posted By: Anne Maxwell, LCSW, RPT-S

Bryan Post says over and over again:  "It is not possible for a child who is dysregulated to become regulated in the presence of an adult who is not."  How true!   Why would we prefer to be emotionally regulated, to experience emotional well being?  What's the payoff?  Again, when we are dysregulated, we are living in our heads -- stuck in the past or perseverating about the future.  What would it take to be in the present, to be attuned and aware, to live with ease and joy?

First, let's look at the early warning signs of dysregulation in us.   These would be the signs that occur before blown gaskets, before screaming and yelling, before slammed doors, before feeling as if you can't go on, before telling yourself how much you dislike everyone and everything involved, before swearing you never signed up for this, before having the awareness that pretty soon you will not be able to stop yourself, and then, actually, not being able to stop yourself.

How does your body tell you that you are becoming upset?  What does it do?  Does it begin to stiffen?   Does it feel numb?  Does it freeze?  Does your stomach start to tighten?  Does it turn into a stomach ache? What about your neck and shoulders?  What about your back?  Do they also tighten?  Do you begin to feel as if your body cannot bend?  What about your chest?  What about your breathing?  Does it become shallow?  Is it labored?  Or do you simply forget to breathe? What about your body posture?  Do you lean forward?  Do you experience a degree of intensity that begins to take on a life of its own?   What about your head?  Does it begin to ache?  Does your mind go blank?  Does it feel as if it is shutting down?  What about your eyes?  Do they become piercing?  Do they take on "the look"?  What about your ears?  Do you begin to hear a ringing in them?  What about your voice?  What about your throat?  Can you swallow?  What about your hands?  Do they clench?  Do you crack your wrists?  For what period of time does your body give you these clues that all is not well, before you become aware?  What does it take for you to listen to your body?  (More about that later!)  Looking back, are you able to see reflections of your state of dysregulation in the responses that the people and creatures in your life have towards you?  Do the pets make themselves scarce?  Do your children continue to escalate?  Do they look frightened?  What about your spouse?  Coworkers? We could go on!

So, what's possible?  What are some choices? Over the next few weeks, I’ll be discussing tools to use during the three distinct periods of time relating to emotional regulation. The first is "in the moment" - when you realize that you are about to lose it.  The second is soon after, when you have begun to regulate, and, would do better by continuing to regulate.  The third is during the rest of your life.  What can you do on an ongoing basis to achieve a greater, more pervasive sense of ease and well being?

Posted in: Tools and Techniques

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A Word About Stomping

July 22nd, 2011 7:30am - Posted By: Anne Maxwell, LCSW, RPT-S

How often have we felt disrespected as the child we were talking to turned tail and stomped off? How about this thought? Perhaps he was regulating himself, with the left, right, left, right movement. Stomping off may seem disrespectful, but it does promote bilateral stimulation. Instead of saying: "Don't you walk away like that when I am talking to you," could we say instead: "I'm glad you are stomping. Stomp as hard as you want. Stomping is good. I love you. When you feel better, do you want to come and sit next to me?" Of course, this presupposes that the adult is in a state of emotional regulation! In all likelihood, after becoming regulated again, he will no longer be disrespectful.

Posted in: Tools and Techniques

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Giving to Those Unable to Receive

July 15th, 2011 6:58am - Posted By: Anne Maxwell, LCSW, RPT-S

I have been considering the question: Is it possible to give to someone who is unwilling or unable to receive?

I shared these stories with some friends/colleagues, who suggested that perhaps what was at work was less a conversation of the heart, and, more the presence of "mirroring neurons," as described by Dr. Siegel, in his book Mindsight.   Mirroring neurons are those that cause us, for example, to yawn when someone else yawns, or invite the baby to wiggle in eagerness when we smile and coo at her, or in this case, permit us, when we are dysregulated,  to become regulated when we are in the presence of someone who is regulated.  Certainly, being in a state of emotional regulation is a necessary ingredient for having a successful conversation of the heart. 

It makes sense to me that mirroring neurons are at work during these times.  However, in the cases of Taylor and my Mom, Debby and I had been regulated when we had talked with them before, and, the results were nowhere near as effective as when we were regulated, and were speaking to their hearts... to alleviate their fears and to reduce their distress.

Not every child (or adult) is able to hear every conversation of the heart.  In fact, there are times where any attempt to communicate with someone who is profoundly dysregulated will simply result in greater escalation.  Additionally, a dysregulated adult is also unable to give a conversation of the heart at that moment either. In those cases, it is wise to back off until the child is calming down, until you are able to give, and until the child is able to receive/hear the conversation.

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Taylor

July 8th, 2011 6:48am - Posted By: Anne Maxwell, LCSW, RPT-S

Taylor, now five and a half years old, lives with her paternal aunt and uncle, Debby and Jerry and their three children.  She has lived with them since the age of 20 months.  Taylor was born to an emotionally volatile and violent, crack-addicted mother, Christina, and an alcoholic father, Mike.  Christina and Mike's relationship was fraught with physical violence, as well as lots of screaming, yelling and crying.  Debby provided day care for Taylor since Taylor's birth.  Debby reports being heartsick every time Christina and Mike came to take Taylor home with them.  She says she was afraid that if she pushed them too hard to be better parents, Christina and Mike would stop bringing Taylor back.  Debby knew that she and Jerry were Taylor's safe haven. Taylor was placed with Debby and Jerry after Debby called the police to report Christina's crack use.

When I met Taylor, she had just turned three.  She had reflux problems, which caused her to vomit throughout the day and night.  She had terrible nightmares as well as night terrors.  Debby reported that Taylor "spent the first 16 months of her life" crying inconsolably.  When I first met them, she continued to cry, although the intensity, frequency and duration had abated minimally.

I met with Taylor and Debby weekly, for a year or so, in family centered play therapy sessions.  Taylor played hard, including both Debby and me in her play.  Typically, Debby was herself - the good Mom - and I represented Christina - the mean Mom.  Over and over, Taylor played out what her early experiences with her parents had been like:  frightening, demeaning, terrifying, soul destroying.  Over time, she was able to modify her early experiences to experiences she wished she had had, and in fact was having with Debby.  She became able to soothe herself in the sessions, with minimal assistance from Debby.  Although the themes in play remained the same, the intensity of emotion diminished.

Debby is an amazing mother - attuned, present, aware, loving, offering reassurance to Taylor.  For a period of time in the sessions, she helped Taylor develop a narrative of her experiences with Debby and Jerry.  They would play with the doll house and doll family members, and, Debby would repeat in the play how she had taken care of Taylor when Taylor was a baby and toddler.  Taylor would shriek in delight.  Taylor continued to blossom.

However, there were still difficult, emotionally charged moments between the two, which were exhausting to both of them.  Debby confided in me her despair at not being able to soothe Taylor predictably, as Taylor could escalate beyond all reason, and, so quickly!   It was at about this same time that the chaplain told me about "conversations of the heart".  I shared this concept with Debby.

Debby had recently become a caregiver for an elderly lady, Joan, who had Alzheimer's.  Debby and Taylor would take Joan to run errands, and, would be Joan's companion twice a week, for four hours each time.  Taylor and Joan took an instant dislike to each other.  Taylor threw huge tantrums during the outings, which were disturbing to all three, and Joan openly criticized Taylor.  Following one particularly violent tantrum in a store, Debby said she remembered the conversation of the heart idea.  She said she picked Taylor up and held her in her arms close to her (Taylor was screaming and flailing).  She said she whispered in Taylor's ear:  "I just want you to know that Joan is not coming home with us.  After we leave here, she will go to her home, and, you and I will go to ours.  We are a forever family, and, Joan is not in our family."  She reports that Taylor stopped screaming instantly and clung to her neck, nuzzling her.  Taylor gave huge, sobbing sighs of relief, and, was fine, not only for the rest of the day, but for most of the remainder of the times they spent with Joan.

I encourage you to try these conversations of the heart with your children, parents, spouses.  I would love to hear about your experiences.

Posted in: Personal Experiences

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Conversations of the Heart

July 1st, 2011 1:58pm - Posted By: Anne Maxwell, LCSW, RPT-S

Touching Hearts is a beautiful physical reflection of a conversation of the heart. A hospice chaplain once explained to me that conversations of the heart are conversations that bypass the left (logical, reasoning) side of the brain, and, "go right to the heart."  He said that these conversations are aimed at soothing a person, rather than convincing them cognitively of a particular point of view.

My mother lived with my husband and me for the last two years of her life.  She had profound dementia, which among other things, caused her short term, and later remote, memories to become extinguished.  For the most part, she was happy, easy and eager to please, loving, transparent, at one with her universe.  However, there were times when she was terribly confused and upset.  These usually had to do with worries about still being alive.  Her thoughts caused her mild agitation, and, she would say to me things like:  "I don't know why I'm still alive... I have no purpose... I shouldn't be here any longer... I am a burden to you."

Using that guidance I had learned from the hospice chaplain, I would talk lovingly and reassuringly to her.  The words I chose were specific.  The conversations were brief, designed only to relieve her current worries.  For example, with regards to the "I don't know why I'm still alive..." loop, I would tell her that I did not know why she was still around either, and that since she was around, I was glad she was here with us.  I would comfort her by telling her that I did not want her to leave sooner or stay longer than she would like, and whenever she knew it was time to go, that would be the right time.  I reassured her that after she was gone, I would miss her terribly and would never forget her.  I would carry her in my heart. I told her that I would be fine, however, as my husband and I were happy together and would continue to live wonderfully.  She was in her 90's, and even though the roles were completely reversed, and I was the one providing her with a secure base, she was still my mother, and, on some level, needed to know that I would survive.  These conversations were soothing to her.  She would breathe a sigh of relief, and, she would become peaceful again for long periods of time.

These conversations of the heart work equally well with children who have experienced significant stress, and, who appear to have lost their right minds.  I have shared this idea with numerous parents who report that these conversations work well with very young children, as well as children of all ages, who are beginning to deescalate from an emotional outburst.  Next time you are faced with another’s outburst, I encourage you to try bypassing the reasoning and persuading and, instead, speak directly to the heart. I would love to hear how it goes!

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