Helping Children Regulate

This is not a poem. Gasp!

Fun fact: I am a Youth Advocate at a domestic violence shelter, which mostly means I work with kids and teens in the shelter to help them determine what their needs are, help them get those needs met, do peer counseling and crisis intervention and on the best of days just play with some really cool kids who’ve been through some really hard things and given them a chance to just be children. Mostly, though, I’ve been organizing and updating our youth resources.

Recently my boss had me listen to a seminar about helping kids regulate after trauma. It was geared primarily toward caretakers, but also people who work with children. I thought that this information seemed like the kind of information that would be helpful to our residents so I typed up the information from the seminary in a hopefully clear and accessible way. Then I thought, there are a lot of parents out there raising kids who’ve been traumatized. I may not be able to get this information to all of them, but maybe I can get it to some of them.

So feel to share it around. I hope it finds its way into the hands of someone who can benefit from it. 🙂

Helping Children Regulate

Adapted from Beyond Consequences Institute’s
An Evening with Heather Forbes

Trauma effects everyone on a very basic level. Trauma can change the way in which a person’s brain works, even on a physical level. The same is true for children, whose brains are still developing and may need some extra help to get back on track after a traumatic experience.

Everyone’s brains and bodies have a “set point” that is how they work under normal conditions. Trauma can change this “set point,” sometimes resulting in increased anxiety, hyper-awareness, depression, post-traumatic stress disorder, and more. In children trauma often “tunes up” this set point, so that a child is more highly aroused than s/he might have been before the trauma. This means a child may be more sensitive to what is happening around him/her, but especially to stress. Quite frequently children will also regress back to earlier behaviors, such as resorting back to tantrums, baby-talk, thumb-sucking, bed-wetting, etc.

Dealing with these behaviors can be tiring and frustrating. For this reason it is important to remember to take care of yourself, as well. Self-care is one of the most important parts of being able to care for a child and help them recover from a trauma. Take breaks when you need to, ensure that you are getting enough sleep and eating well, and set time aside to do something just for you, like taking yourself to a movie or to dinner or going to the gym. Ensuring that you are fully charged will better prepare you to help your child recover.
Children who have experienced a trauma may act out in a variety of ways. It is important to shift toward thinking about what is happening inside of a child’s brain and how they are attempting to regulate rather than thinking about the acting out behaviors on their own. The acting out is only a symptom.

A well-regulated child:

•    Can handle stress
•    Has functioning circadian rhythms (what controls our body’s “schedules”)
•    Has an effective digestive system
•    Can be patient, kind, and loving
•    Can control his/her impulses
•    Has flexibility and an even temperament
•    Enjoys new experiences, is curious and willing to try new things
•    Listens and processes information

However, trauma disrupts many of these things with stress and fear. Trauma robs children of their natural curiosity and replaces it with a need for things to be stable and consistent. This need is often so strong that new experiences become scary.

Children can’t be sure that they’re okay or are going to be okay. They are still working out of a place of uncertainty and many times we see this in the way children act out. It may be obvious to us or to other adults that we are only trying to help, but a child who has been traumatized might not understand this. That you are trying to help might not be obvious to a child, and s/he might resist our attempts to help. While frustrating, this resistance is actually coming from an instinct of self-preservation.

Children who have experienced trauma and whose regulation has been disrupted will still attempt to regulate themselves. Likely, they will try to regulate using behaviors that are disruptive and disturbing to others but are not effective for actually regulating themselves.  In young children this might include:

•    Tantrums
•    Yelling
•    Shutting down
•    Picking at skin, hair, nails
•    Obsessive compulsive behavior
•    Fidgeting and squirming
•    Isolating themselves
•    Immersion in electronics (the internet, videogames, etc)
•    Anything to avoid feeling the severe emotional pain trauma has left them with.

Because a traumatized child will want to avoid directly dealing with the feelings their trauma may have left them with, they may project their feelings onto others. Rather than confronting their pain, fear, anxiety, etc. they may find it easier to place anger and blame on someone else. Older children and teens may do this as well. Ineffective attempts to regulate in older children might include:

•    Smoking, drugs, and/or alcohol
•    Sex
•    Cutting and other self-harm behaviors
•    Stealing
•    Partying
•    Shutting down
•    Isolation
•    Again, anything to avoid feeling the severe emotional pain trauma has left them with.

So, how do we help children recover from trauma and learn effective strategies for regulation? First we must understand what is happening in the brain after a traumatic event.

A regulated brain works from the “top down”: the neocortex is the outer part of the brain, where rational and “higher” thought, judgment, and morality happen. This part of the brain is dominant over emotions and “lower” brain functions, which happen in the limbic system or “mid-brain.” Because the neocortex is dominant over emotions, well-regulated people are capable of controlling or expressing their emotions in healthy and productive ways.

On the other hand, an un-regulated brain works from the “bottom up,” meaning that mid-brain takes a dominant position in the brain rather than the neocortex. What this means is that emotional responses can and often do override more rational, reasoning thoughts. The amygdala, also known as the “fear center” of the brain, becomes programmed by trauma to “stay on,” making a person very fearful and full of anxiety most or all of the time.

This brings us back to the “set point” being tuned up. When a child’s set point is tuned up, their “normal” changes. Their body and brain learn that higher states of arousal are normal and may become anxious when their surroundings don’t fit with that expectation. This may lead to acting out behaviors that will re-create an environment that matches what their brain is expecting, such as stealing something or getting into fights. This creates a sense of risk and heightens adrenalin in the brain, bringing them back to their higher set point, since this now feels normal.

The brain must first be calmed before these acting out behaviors can be corrected. Responding to these behaviors with consequences or punishment is a fear-based tactic and may actually keep them in a “bottom up” regulation in their brain. It might seem counter-intuitive but because of this, placing consequences and punishment on these behaviors (the symptoms) might actually be counter-productive to helping a child recover and fixing the root cause of these behaviors. Instead we must find ways to allow children and youth to express themselves, their trauma, and the pent up fearful, confused, stressed, and angry feelings that their trauma has left them with.

We must remember that a child who is un-regulated or acting out after trauma is living with so much internal chaos that they struggle to calm down and often can’t calm down at all. We can think of this as being the result of energy trapped in their bodies: something traumatic happened to them and they were unable to respond. They probably wanted to respond with a self-preserving action, such as fighting or running away, but they couldn’t. That unreleased energy is stored in the body as a part of their trauma experience. This energy can and often does rise to the surface, triggered by seemingly unimportant things, and the child “erupts.”

When this happens, we should allow the child to do so. Allow him/her to let it all out. This eruption of emotion may seem inappropriate and our first instinct may be to correct the behavior but we would be preventing the child from expressing what they are experiencing internally. Without the ability to express their internal world in a way which is true and honest to that experience, especially when they may not have the language to express that experience in a more “appropriate” way, those feelings will stay contained inside of the child’s mind and body.

Children need to express what is happening inside of them and sometimes, especially if they have not had the opportunity to express it before or do not have the language to communicate their experiences, this expression could be explosive. While we want to give them space and time to express their feelings and experiences before we attempt to correct any troubling behavior or language, we also want to ensure that they are “erupting” in a safe way. Some ideas for safely discharging the feelings of trauma include:

•    Punching bags, hitting or kicking pillows
•    Running
•    Laying on the bed to kick in the air
•    Stomping
•    Throwing or slamming a weighted, dynamic medicine ball
•    Activities that are physically exerting.

Some ways of verbally discharging or expressing trauma feelings include:

•    Yelling
•    Grunting
•    Swearing
•    Screaming
•    Giving trauma energy and feelings a sound of any kind.

Whatever you may find that works for your child to safely express their emotions and internal experiences, it is important that you do these things together. Building or strengthening a relationship with your child is going to be one of the most important aspects of your child’s healing and helping them return to healthy regulation. Positive and healthy relationships, but especially a positive and healthy relationship with you, will help to provide the support and stability and feeling of security necessary to healing. For this reason it is very important that, however your child is choosing to discharge their trauma and trauma related feelings, you are there with them and for them. They need to know that they are not alone, no matter how bad it may feel for them.

Firstly, just listen and hear what it is your child is saying. They may be projecting their feelings or have views that don’t match up with yours. Some of their views may be quite mixed up, but your first priority should be to let them voice their perspective and to hear it out. Once you’ve heard what they have to say and they are calmed, then you can talk to them about it. Rationalize through some of the things they expressed which may not line up with what you know to be true. Try to avoid blaming them or in other ways making them feel bad for their views and perceptions. Rather, talk through it with them. Acknowledge their thoughts and feelings while calmly and rationally telling them your thoughts and feelings and gently correcting any incorrect views they might have.

In addition to this there are a number of basic needs considerations you will want to think about while helping your child overcome their trauma. Sleep and nutrition are among the first needs that must be met so that your child is healthy and has the energy s/he needs to undertake the very tiring task of healing and learning how to regulate. Here are some tips to help ensure that your child is getting enough sleep and eating well:

Sleep
•    Establish bedtime routines. When the mind and body start associating certain behaviors with bedtime and sleep (taking a bath, brushing teeth, reading a story, singing a lullaby, etc.) then those behaviors will begin to help relax the mind and body in preparation for sleeping.
•    Turn off electronics some time before bed. The artificial noise and light from smart phones, game consoles, TVs, etc. often times stimulate the brain so that it cannot calm itself in preparation for sleep. Some studies suggest that the artificial light of such devices can disrupt sleep hormones in the brain if used too close to bedtime.
•    Fans and white noise machines can help to drown out external, disruptive noises to better allow for peaceful sleep. The white noise can also be quite calming.
•    Sleeping in bed with your child or otherwise establishing a co-sleeping arrangement, such as sleeping on the floor in your child’s room or sleeping in the hallway outside of your child’s room, can help to establish a sense of security and help your child to sleep better. Sleeping near to your child can also help with bonding between you and your child.
•    Creating a sense of safety at nighttime is of the utmost importance in ensuring a child who has been traumatized is able to get the sleep he or she needs.

Nutrition
•    Model healthy eating for your child. If they see you routinely eating healthy foods, they are more likely to be receptive to eating healthy foods.
•    Make sure you are aware and cautious around any allergies or intolerances. An allergic reaction or trouble processing food can take quite a toll on the body, especially a young and already stressed body.
•    Keep meals on a schedule. The routine will be helpful both for helping your child feel secure throughout the days and for having established times that your child associates with food and eating, and so will encourage them to engage with routine, scheduled meal times.
•    Stick with more natural foods, as these are what our bodies were designed to eat. They are easier for the body to digest and the body can get more out of natural foods.
•    Consider limiting starchy, sugary foods as these are often linked to health troubles. Some people have trouble digesting gluten and dairy so minimizing or removing these things from your diet may help with digestive regulation.
•    Vitamins and Omega 3 fatty acids are reported to be helpful and healthful for brain function.

In addition to these things you might want to consider taking some precautions to avoid stress or decrease stress for your child. Trauma and the feelings that come with it are big, scary, confusing and tiring things to process and recover from. Children might need more time to process, and they might be easily confused by what they’re trying to work through. Especially after a trauma, a child’s tolerance for stress can be quite low. They might need everything to just slow down a little, and while you can’t slow the world down for them, as much as you might want to, there are some things you can do to help give your child the time and space to process:

•    Avoid large crowds and chaotic environment
•    If going into public, give your child plenty of warning and spend some time talking to them about where you are going, who they might see, why you’re going there, etc. Make sure they have a very good grasp of what’s happening so they are prepared for an outing which might otherwise be stressful.
•    Rehearse what you will be doing if going out, so that they have a plan of action and feel prepared.
•    If there are friends or family members which cause you or your child stress, avoid them. You and your child both are under enough stress and don’t need any more unnecessary anxiety on top of that.
•    Create routines, rituals and traditions within your daily lives. This will instill a greater sense of calm, as things will be familiar and predictable. A good resource for creating daily routines, rituals, and traditions is I Love You Rituals by Dr. Becky Baily.

Once you have helped to make time and space for your child to work through their trauma and feelings, there are many positive and effective regulating activities you may help your child engage in to replace ineffective or harmful regulating activities.

•    Rocking or swinging, perhaps in a hammock or a rocking chair if you have access.
•    Breathing exercises, such as with blowing bubbles, blowing up balloons, belly-breathing exercises.
•    Listening to music they enjoy, especially soothing music.
•    Playing musical instruments can be quite enjoyable and expressive for some children.
•    Writing can be a safe way for children and youth to privately explore their feelings and experiences, or to “write it out.”
•    Knitting and crocheting can be good regulating tools as the repetitive motion and patterns can be quite soothing.
•    Coloring books might give children an external focus and allow them time to calm and sooth themselves.
•    Because time-outs can be perceived as rejection and because they ask children to regulate themselves when they may not have the know-how, tools, or ability to do so, time-outs are counter-productive and should be avoided.
•    Meditation helps to reduce stress and anxiety but may not be appealing to children and teens. Invite them to meditate but don’t enforce it. Model it instead.
•    Yoga can be helpful with stress and anxiety by engaging the body in soothing stretches and breathing exercises. This has similar effects as meditation and may be more appealing, so if your child isn’t interested in meditation try inviting them to practice some yoga at a later date.

In addition to these activities, there are a number of sensory techniques you and your child could use to help with regulation:

•    Sitting on bean bags or hugging/snuggling body pillows
•    Fidgeting toys such as stress balls, hand-held puzzles, rubix-cubes, etc.
•    Sleeping with a weighted blanket, wearing a weighted vest. These are often made specifically to help people with anxiety.
•    Hand exercises
•    Rice tray
•    Quiet time, with reduced noise and light
•    Texting with your child might provide them an opportunity to communicate with you and express what’s happening with them while at the same time engaging them in small hand activities and a tactile experience.
•    Sitting with their back against a wall can provide additional grounding.
•    Bear hugs
•    Lotion rubs, essential oils, or massages
•    Soft clothing, going barefoot
•    Worry stone or crystal
•    Bubble or Epsom salt bath
•    Sitting on exercise ball instead of chair

Finally, it is important to once again remember that this is hard work. It can be quite frustrating and very draining. If you are exhausted or at the end of your rope it will be much harder for you to help your child. Remember that there is no shame in asking for help or taking time to take care of yourself. Don’t beat yourself up if you do need to ask for help or take time away to gather your emotions, calm down, or just get some rest and do some important self-care. You’re doing what you need to do to take care of your child and yourself.

By working attentively with your child to uncover what he or she needs and helping them to express their thoughts, feelings, and experiences, and helping them to explore and learn new, positive ways of regulating, you are helping them move toward a place of being able to healthfully and positively self-regulate.

Continue to check in with them along the way: ask them what they’re feeling, how that feeling feels in their body or where they feel it in their body to help them learn how they experience their motions and how to name and communicate them to others. Allow them choices so that they get to have control over themselves—ask them if they need to take a break from something that is stressing them out instead of enforcing a break, when they’ve calmed down ask them if they are ready to return to the activity or if they want to, etc. Allowing them control over themselves will enable self-awareness and let them know that what they want and need does matter. These and other strategies discussed here will help guide them toward understanding themselves, their experiences, and making decisions based on healthful regulation.

It is a slow and difficult process but with time and patience and you will begin seeing your child recover and learn how to regulate themselves. Healing and regulation can sometimes be elusive and despite how frustrating that can be, it is okay. Sometimes you might need to acknowledge, “We’re all un-regulated right now but we’re going to be okay.” Sometimes you might need to allow it to be what it is, and this can also help create regulation by allowing kids to just be who they are.

 

More information about child traumatic stress can be found at The National Child Traumatic Stress Network.

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