Showing posts with label Emotional Regulation. Show all posts
Showing posts with label Emotional Regulation. Show all posts

Tuesday, August 16, 2016

A Quick Fix to Over-Sensitivity

Today was a dentist day. Now, in spite of being over-sensitive to just about everything, I am good with going to the dentist. As a child, I had a great dentist who told me to focus on something else while he worked on my teeth. I did so and got through the procedure without too much discomfort. It was a good lesson.

But I didn't generalize on it until much later. I was in the midst of a home remodeling project and hammered my thumb instead of the nail :{  I was dramatically in pain. A friend told me I was a wuss, and that I should focus my attention on something else until the pain died down. I did it, and miracle of miracles, it worked. How did he know that and I didn't. He had played sports. I had not. Sensory kids don't.do.sports because it's noisy and you get bumped a lot. And that's the point of this post sensory kids naturally react differently to pain, bumps and sounds and they avoid activities like sports where kids get so many life lessons, including "think about something else".

If Zoey is playing in the sprinkler and gets water in her face, she can focus on it with discomfort, or she can shift her attention outward to something else, like the sprinkler itself, her chest or her hands. If Martin is standing next to an alarm that sounds for several seconds, he can bring his attention back into his body (and his hands over his ears) and in that way stay grounded.

This particular lesson is a game changer, and here's why. Our brain operates with great efficiency, always trying to guess what to be ready for. If I focus on sensory discomforts, the brain says, "That's what she wants to pay attention to", and so it prioritizes the brain's focus to discomforts. On the other hand, if I am able to ignore the discomfort, and focus on something else, discomfort loses priority. What a concept. Discomfort loses priority, and we don't attend to it. What a great lesson for our kids!

By the way the circuitry that processes priorities is in the right anterior insular cortex (rAI). It feeds priorities to the anterior cingulate cortex (ACC) which takes action: behaviors, motor and emotional reactions and cognitive redirection. ....but that's a post for another day.

Monday, June 27, 2016

My latest book, Hands-On Activities for Children with Autism and Sensory Disorders is available through my publisher, PESI.com, and at Amazon. It has all new interventions and focuses on sensory, especially multi-sensory, activities. Topics include Environmental Enrichment for children with autism, sensory enrichment for all children, and aerobics for the classroom. It's great stuff. Check it out!

As I begin to work on my next book: self-regulation strategies for the Pre-K to grade 2, I'll be previewing topics in my blog posts. So stay tuned for lots of great new material!

Teresa

Monday, December 31, 2012

Polyvagal Theory, Sensory Challenge and Gut Emotions

Have you heard about Dr. Stephen Porges' Polyvagal Theory? The theory, already 20 years old,  replaces our old notions of how the sympathetic (fight/flight) and parasympathetic nervous systems (rest and recuperation) help to keep us calm, alert and safe. The area covered by Polyvagal Theory is huge. It impacts the way we understand our nervous system, senses, emotions, social self and behaviors. We see diagnoses like autism, sensory modulation disorder, borderline personality and others, in a new light.

Polyvagal Theory claims that the nervous system employs a hierarchy of strategies to both regulate itself and to keep us safe in the face of danger. In fact, it's all about staying safe.

Our "highest" level strategy is a mechanism Porges calls social engagement. It is a phenomenal system - connecting the social muscles of the face (eyes, mouth and middle ear) with the heart. You knew that your heart came alive with social interaction, and it's true! This system is regulated through a myelinated branch of the vagus nerve. In evolutionary terms, this is our most evolved strategy (mammals only) for keeping ourselves safe. We use this all the time to clear up misunderstandings, get help, plead for forgiveness, and so on.

The next mechanism, or strategy, is fight or flight. It's regulated by the sympathetic nervous system. This system is our fall-back strategy when social engagement isn't a good fit. (Think of seeing someone sneaking up on you!) Note that freeze is not a part of fight or flight.

Our freeze option is primal and is a remnant of our reptilian past. Freeze is a great strategy for turtles and lizards, but it's usually a bad idea for humans - think of fainting. Therefore, we typically use it last, when social engagement and fight/flight aren't going to work for us. But there are good uses for freeze. During severe injury, it shuts us down and turns off our registration of pain. We also make use of it during sex, and it helps women regulate pain and response to pain during labor.

Now these systems appear to work in tandem. The social engagement system puts the brakes on the other (fight, flight, freeze) strategies, thus keeping our heart and body active while we work through a situation. The social engagement system will release the brakes to engage a different response to the environment (i.e. running) if engagement doesn't help to get us into a safe situation.

What Can Go Wrong
We want our nervous system to operate using the social exchange most of the time. It is our most evolved way of being. It is restful and healthy because it allows our gut and other organs to do their job uninterrupted.

However, some of us are programmed from an early age to work from a fight/flight mode. Think of people who are sensory sensitive and recoil from sound, touch, smell or taste. Think of people with autism (in this case, the face to heart connection is not working). Think of people with borderline personality, depression and perhaps other disorders, too. When we are not able to work from our social engagement strategy, then we revert to a modified fight/flight strategy, which puts us in high alert. If we use too much of the fight/flight or freeze strategies, we may end up with gut issues because the gut comes to a halt and we stop digesting food during fight/flight activation.

The Polyvagal Theory has gained great acceptance over the years as pieces of it are shown to hold under laboratory findings. From a psychological viewpoint, it provides us with a rich understanding of self-regulation in the body. From a sensory processing viewpoint, it informs our understanding of sensory modulation.

If you are unfamiliar with the topic, check out the many articles on Dr.Porges' website. The most comprehensive article is The Polyvagal Perspective, and it is published here on the NIH Public Access site. It contains the physiological underpinnings of the theory as well as perspectives on  development, emotions, trauma and many other topics. There is a short video of it here.

Sensory Connection
Two researchers looked at a biological marker of the social exchange system, RSA, in typical children and in children with sensory modulation issues. RSA is the measure of high-frequency fluctuation in the heart between heart beats. It is a window into the social exchange system. The researchers found that children with sensory modulation issues have a lower level of RSA than their peers, meaning that these children are better prepared to put the breaks on social strategies and instead use fight-or-flight strategies.

As part of the study, the children were (each in turn) given a sensory challenge. The chairs they were seated on tilted backwards unexpectedly. The level of RSA was monitored in each child throughout the incident. The RSA of typical children dropped quickly and then stayed low for a short time. The children with poor sensory modulation skills had a very brief drop of RSA and a quick rebound to their RSA baseline.

This implies that children with sensory modulation symptoms use different strategies to handle safety-related situations than their peers. At this time, it is harder to draw greater conclusions since we do not have an easy-access window into the fight/flight system or the freeze system. With time, we'll get a better understanding of this. The article can be found here.

Emotions
Perhaps the most interesting new work making use of the Polyvagal Theory is the work of A. D. (Bud) Craig. Mapping our emotions, this is what he found. (Read about it here.)

Emotions arise from feelings in our organs and gut. The feelings are sent via the vagus nerve to the Anterior Insular Cortex (AIC) in the brain. (There's a lot going on in the vagus nerve - think of it as a cable with lots of separate wires.) The AIC captures feelings over time  and stores them as snapshots of feelings. This is our working emotional memory. These feelings are massaged and integrated with the social exchange to give us both an emotional response to the world around us as well as a safety-driven strategy.

Think of this: I am relaxing in a lounge chair on the beach. I feel safe. Suddenly, a beach ball hits me. My fight or flight instinct kicks in and the sympathetic nervous system stops everything that's happening (i.e. digestion) in my organs and gut. The gut passes the feeling of stoppage as "alarm" to the brain. This translates in the brain to fear and my body is set in motion. I quickly turn and see it's a ball and that a child is nearby and smiling at me. My social engagement strategy puts the breaks on my fight/flight response and also calms my heart. I smile at the child. This sends a sense of relief to my gut and it in turn sends a "warm" feeling to the AIC. My heart is still pounding from the surprise, but my response is guided by compassion.

In the above scenario, we specifically looked at a situation with a challenge to safety. But in fact, we spend much of our time worrying about safety. Unless I am completely safe, listening to quiet music in a locked room, I will most likely have safety challenges to respond to. The challenge may be from the scary book I am reading, or from the sense of anxiety I feel when I drop a spoon on the floor. Almost any activity will involve the combined interaction of the various strategies. The bottom line: we are constantly adjusting ourselves to meet the world. Polyvagal Theory gives us a look at how this works.

This is pretty complex stuff - and the theory is still in flux. It changes with each new study that looks at the implications of Polyvagal Theory on our response to the world. It is going to impact research greatly in the years ahead. As I mentioned at the beginning, Polyvagal Theory adds a new dimension to how we see autism, sensory issues and other disorders and will, I think, inform our interventions for those disorders in a big way.

References:
  1. Porges, S. W. (2008, February). The Polyvagal Perspective. NIH Public Access, PMC1868418
  2.  Schaaf, R. C., Benevides, T., Blanche, E. I., Brett-Green, B. A., Burke, J. P., Cohn, E.S., Koomar, J., Lane, S. J., Miller, L. J., May-Benson, T.A., Parham, D., Reynolds, S., Schoen, S. A.  Parasympathetic Functions in children with sensory processing disorder. Front Integr Neurosci. 2010; 4: 4. Published online 2010 March 9. doi: 10.3389/fnint.2010.00004
  3.  Craig, A. D. (2009). Emotional moments across time: A possible neural basis for time perception in the anterior insula. Philosophical Transactions of the Royal Society of London. 364,1933-1942.

Thursday, December 27, 2012

2012 Journal Tidbits - Autism

Here are some study findings from the Journal of Autism and Developmental Disorders - one of my favorite journals - that struck me as worth sharing. By the way, you have until Dec. 31st (2012) to browse this journal for free on line.

 1. Is picky eating due to sensory issues or due to food rigidity?
This article suggests that some picky eating problems are due entirely to rigidity in the child's food selection patterns. Treatment in this case is motivational. A child is told they will try a certain food. They are offered a choice of reinforcers (rewards). If they eat the food, they receive the reinforcer. They are also rewarded with accolades.  If they do not eat the food, they do not get the reinforcer.

When trying a new food, the authors followed a hierarchical pattern similar to Kay Toomey’s SOS Approach method:
  1. Touches the food
  2. Puts food to the lips,
  3. Bites the food, bites
  4. Puts in mouth but does not swallow
  5. Chews but does not swallow
  6. Swallows reluctantly
  7. Accepts food without signs of displeasure.
After18 weeks, children were spontaneously requesting the new foods they had tried. The three children in the study, Ken, Robbie and Daniel accepted 5, 9 and 8 new foods respectively at the completion of the 22 week study.

  
2. What causes self-injurious behaviors in autism? The seven risk factors for self-injurious behaviors are 1) poor sensory processing, 2) low cognitive skills, 3) poor language / communication skills 4) poor social function, 5) age (18 mo. - 19 yrs.), 6) rigid behaviors and 7) gender. However, these factors account for just 29% of the self-injury cases seen, with sensory being the greatest factor of these (5-7%). The authors hypothesize that chronic pain and psychosocial factors may play a large factor in the remaining 71%. Clearly, there is more work to be done.


3. Is there a relationship between anxiety and repetitive behaviors? Yes, repetitive behaviors appear to be a cause of anxiety. "It is possible that, for some individuals, interventions focused on a reduction of behaviors, promoting flexibility and reducing repetitive play may consequently reduce anxiety." See the next article for more on this.

4. Are there interventions for quieting repetitive behaviors? Yes, if the child's behavior can consistently be triggered. For example, give a child with autism six cars, he will line them up. That behavior is triggerable and can be replaced with functional behavior. How about if the behavior is not triggerable? That's a harder problem. Not only do we not have interventions, we are not doing the research to look for them.

Sources:
  1.  Boyd, B. A., McDonough, S. G., Rupp, B., Khan, F.,& Bodfish, J. W. (2011). Effects of a family-implemented treatment on therepetitive behaviors of children with autism. J Autism Dev Disorders,1330-1341.
  2.  Boyd, B. A., McDonough, S. G., F., & Bodfish, J.W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism.J Autism Dev Disorders, 1236-1248.
5. Do children with autism also qualify for anxiety disorder? Yes, the diagnoses overlap often in children and young people (40-45%). Specifically, in children with high functioning autism, anxiety should be treated (medicine or stress reduction techniques) as a way of supporting other methods of increasing social skills.

Friday, November 30, 2012

Aromatherapy and Essential Oils

A recent study (1, 2) showed that essential oils reduce blood pressure and heart rate - but only if they are used for 15 - 60 minutes at a time. There is evidence that they reduce heart rate, but they can cause other issues (asthma, for example) in longer doses.

Aromatherapy is often touted to help reduce anxiety. The National Institute of Cancer (NCI) says this about it:

A large body of literature has been published on the effects of odors on the human brain and emotions. ... Such studies have consistently shown that odors can produce specific effects on human neuropsychological and autonomic function and that odors can influence mood, perceived health, and arousal. These studies suggest that odors may have therapeutic applications in the context of stressful and adverse psychological conditions.

The NCI (3) looked at a research done with cancer patients using aromatherapy to treat anxiety and other symptoms of cancer. The studies, which included children, show that aroma therapy can be effective - and especially when combined with massage. Here are some of the results. The full results are here.
  • Chamomile combined with massage appears to work well.
  • Smelling and tasting orange helped with physical symptoms of cancer treatment in children. There was no report on its effect on anxiety.
  • Various essential oils (selected by patient) appear to reduce anxiety.
  • Bergamat did not work and in fact, increased anxiety in children.
  • Lavender did not appear to work as a relaxant in these studies. By the way, there is some evidence that exposure to lavender in boys and men can enlarge mammary glands.
As noted above, essential oils should be used for only 15 - 60 minutes at a time.
 
For more information on essensial oils and aromatherapy go to:

References:
  1. Chuang K-J, Chen H-W, Liu I-J, et al. The effect of essential oil on heart rate and blood pressure among solus por aqua workers. Eur J Prevent Cardiol, 2012 DOI: 10.1177/2047487312469474 
  2. A synopsis of the above article is at ScienceDaily: Mind&Body:  http://www.sciencedaily.com/releases/2012/11/121129093419.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29
  3. Study with cancer patients:  http://www.cancer.gov/cancertopics/pdq/cam/aromatherapy/healthprofessional/page7

Autism and Fear

Researchers at Bringham Young University showed that children with autism hang on to the association of fear for a particular object long after other children have let it go. In a series of trials, children were given a puff of air in the face after seeing a yellow card. All of the children registered fear when shown a yellow card. At some point the card associated with the puff of air was switched to a differerent color. Typical children figured this out quickly and soon lost their distrust of the yellow card. Children with autism continued to be fearful of the yellow card long after the others. The length of time they stayed fearful was related to the severity of thier autism diagnosis.

The authors conclude that this heightened sense of fear ("anxiety", in their words) is not just associated with autism but is an integral part of it.

References:
1. Synopsis can be found at Science Daily: Mind and Brain

2. Mikle South, Tiffani Newton, Paul D. Chamberlain. Delayed Reversal Learning and Association With Repetitive Behavior in Autism Spectrum Disorders. Autism Research, 2012; DOI: 10.1002/aur.1255

Saturday, August 18, 2012

EFT Post Update


Here is an update to the original EFT post of a few weeks ago.

The Emotional Freedom Technique is an easy way to deprogram the brain of emotional garbage. The basic idea is that you tap on acupressure meridians while bringing up difficult emotions or memories followed by saying positive things (affirmations) about yourself. The claim is that the emotions disappear and the memories become neutral. The evidence says that it is effective and my own quick experimentation with it has sold me on it. Bad memories were indeed neutralized. It felt a bit like magic.

There are a number of YouTubes that demonstrate the method, including how to do this with a child. You will want to read The EFT Manual by Gary Craig before you try it. And by all means, don't do it on others if you are not professionally capable of handling the situations you could get into. There are lots of workshops out there that can give you a hands-on approach to learning it.

Here are the basic steps:

1. Name an emotion you are feeling.

2. Create an affirmation:

      But even though I am (emotion), I deeply and completely accept myself.

      Example: Even though I am angry, I deeply and completely accept myself.

3. Tap side of palm while saying affirmation.

4. Tap head, face and other points while saying emotion.

5. As you move to the wrists, say the affirmation again. 

6. Do steps 3-5 for several rounds until the emotion eases.


Doing EFT on the memory of an emotional incident
1. Name the memory (i.e. “fight with Sarah on the playground”).

2. Create an affirmation (as before).

3. Tap through the name of the memory until the child can say it without emotional reaction.

Now very slowly begin to play a part of the memory. Stop and tap until you are comfortable with it, then continue on with each section of the memory in the same fashion. You do not have to do the entire memory in one setting – break it up and do what is comfortable for you. Long or highly emotional memories will take a while. 

Older memories may have layers and layers of thoughts and emotions connected to them. Perhaps the child gets through one aspect (embarrassment of the situation) only for another aspect (fear of Sarah) to show up next.


 There is so much more to learn, but this is enough to experiment with. Remember – read the book, watch the YouTubes, practice on yourself and see how it works for you.

Sunday, July 15, 2012

EFT - The Emotional Freedom Technique



The Emotional Freedom Technique is an easy way to deprogram the brain of emotional garbage. The basic idea is that you tap on accupresure merideans while bringing up difficult emotions or memories followed by saying positive things (affirmations) about yourself. They claim that the emotions disappear and the memories become neutral. The evidence says that it is effective and my own quick experimentation with it sold me on it. Bad memories were indeed neutralized. It felt a bit like magic.
There are a number of YouTubes that demonstrate the method, including how to do this with a child. You will want to read The EFT Manual by Gary Craig before you try it. And by all means, don't do it on others if you are not professionally capable of handling the situations you could get into. There are lots of workshops out there that can give you a hands-on approach to learning it.

Gary Craig's web site is EFTUniverse.com.

Friday, April 6, 2012

MeMoves

MeMoves is an engaging exercise for small or large groups. Its developers describe it as "a kind of Western t’ai chi or yoga set to music". Children watch and imitate images of slow rhythmic movement and in the process get calm and improve attention skills. In children with autism it fascilitates the function of the mirror neurons.

The original product is a DVD with a variety of moves and costs $59. Watch the children below work to it.



There is also a MeMoves app for iPhone which helps with calming and focus, but without the whole-body movements. It is $10.




I've heard this described as a timing program - but I'm going to disagree with that. It is rhythmic, and the children are doing coordinated movement, but in what I've seen thus far, the stress is on calming and attention rather than on precise timing. In any event, it appears to be a great product! Find out more at ThinkingMoves.com


Friday, December 16, 2011

Building Emotional Muscle

Kerry Kelly Novick and Jack Novick are psychoanalysts in Ann Arbor, MI who write a blog for parents called Build Emotional Muscle. Here is the link to a post about a six year old boy who is refusing to go to school. I love it!