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A Thought

In this life we can not always do great things. But we can do small things with great love.." :) Mother Teresa

Prayer Quote

“I pray because I can't help myself. I pray because I'm helpless. I pray because the need flows out of me all the time- waking and sleeping. It doesn't change God- it changes me.”
― C. S. Lewis


I believe in the sun even when it's not shining. I believe in love even when I don't feel it. And I believe in God even when He is silent. (quote found on the wall of a concentration camp)

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Wednesday, May 8, 2013

Angry Episodes and Impulse Control Issues

Fatcat asked a couple of good questions, that I would like to answer if I can.

She asked,  "How do you coach a child through an angry episode?"  And, "How do you deal with impulse control issues."

For both of those.... "VERY CAREFULLY!"

When a child is angry and has impulse control issues, things can become quite volatile quickly!

The best thing you can do is have a tool box ready for you and for your child that has ample tools to choose from! 
The tool box has been the best thing we have ever used and we have been using it for nearly 10 years when our first daughter came home.

The key is teaching them to use tools when they are calm to prepare them for when they become dysregulated.

One of Alli's favorites is the "magic mustache", and "deep breathing with mom".  With the magic mustache, you press between your upper lip and nose and it has a calming effect on the brain.  Deep breathing can put you in rhythm together and gets extra oxygen to the brain to help a person calm down. 

We had a bit of an interesting week over here with the perfect storm happening that I blogged about several days ago.  Things have calmed, but it was not an easy time for any of us. 
Children from Trauma backgrounds can get stuck, or in a rut, and sometimes it is hard to help them out of that place. 
If we don't carefully differentiate between focusing on behavior, vs. helping a child through a crisis, it can be nearly impossible to help our children out of dysregulation.  It is easy to forget this. It is also costly. A child as well as a parent can get stuck in what is called, "A negative feedback loop".  Negativity feeding off of itself will not bring about regulation, ever.

I learned a few things in the last 2 weeks, that I would like to share. 
Communication problems become even more complex when a child is dysregulated.  If English is not a first language and communication seems ok when regulated, this will not be the case when they are dysregulated. All complex thinking goes out the window!  Even for children who are native English speakers, dysregulation causes a shut down when using words to communicate.

Last week, Alli said,  "All I'm hearing is blah, blah, blah!" 
While disrespectful, there was a message in there for me to pay attention to....
And I didn't. 
Instead, I focused on the disrespect, (which DOES need to be dealt with in the right time)  but I focused on it, using more words! Duh
I was focusing on the behavior and not the child.  This is the hardest concept of all, in my opinion to understand.  If we zero in on the behavior, we are looking at a "symptom" and not a "root".
Our kids know that they have struggles.  They understand that they are out of line.  They really don't need us to point that out to them. 
Many times they are so filled with shame,  having somebody point out an obvious wrong, tips the already full, bucket over.

So the dysregulated child who already told me I was using too many words,  shut down!
It wasn't until my sweet husband said, "You are talking too much."  "Keep it simple."
He was right. 
I was being kind, I was being gentle, and I was talking too much which was causing her more frustration. I was also focusing on a behavior and not what was behind the behavior.

I love it that Mike and I can be a team together.  Sometimes he can point out the obvious that I don't see, being in the moment all the time.
I needed a fresh perspective, and my dear husband was able to provide that for me.

I was reminded of this scene for Amadeus:
Instead of "Too Many Notes", it was "Too many words!" :)

Rubbing a person's back and simply being present, is helpful. Waiting for a child to calm themselves and then just sitting with them can help them be calm faster.

There is always time to talk when you are not "in the moment". 

Our youngest daughter does have impulse control issues when she is dysregulated.  It takes time to work through them. She has been home just 2 years, but has made great strides in this area. 
When I see her headed to dysregulation, getting her focused on art work seems to be the most calming for her, or just being present.   But being present does not necessarily mean holding or touching.  Just being in the same room.  I have learned to read her body language pretty well and can tell when she is ready to snuggle and when she isn't.

I remember in training with Heather Forbes and  Eric Guy, they talked about a situation where a young man was being restrained by about 6 people in a psychiatric Unit.  Eric was there to see him.
He requested that everybody leave the room and allow him to try something different.

He went into a room where a young man was totally out of control, sat down, but didn't make eye contact.  The young man stopped, came and sat down near him, and when Eric asked a simple question like, "How are you doing?"  The young man broke into tears and calmed down.

His point was, it doesn't need to  take 5 people to tackle somebody and force them into compliance.
If a situation escalates into restraining or force, we have gotten off of the boat somewhere and are dealing with more than just the other person's issue. 

Those words have resonated with me for the last 4 years since I took that training course.  I wish I would have remembered them last week! LOL

There is a lot of talk about "Mandela's" right now.  I don't have a clue why they are called "Mandelas", but saw a picture of one, and found that the art books we have are very similar to those.   They are complicated designs that the girls enjoy coloring. 
One book  I have is called "Images: The Ultimate Coloring Experience" by Roger Burrows.  We have several complicated coloring books, not meant for small children.  I really like Burrow's book though.
I need to get more. :)

Just like us, our kids will never stop learning. And I find this to be very encouraging.  Oh how I wish trauma didn't exist.  But it does, and it is real.  Those of us with children from hard places, live such different lives and realities from typical families. 
I have been a mother in both situations, raising 4 boys and now 4 girls. 

Trauma doesn't go away. It does color a person's perception of reality. 
Helping them understand ways to cope and move through a stress is a challenge, but so very rewarding when we see them succeed! 
Gently, carefully, with great compassion and precision, like a surgeon of the heart, describes the kind of parenting our kids need.

As the children grow and learn, trauma becomes less and less of a trigger, and life skills take over. It is the time in between that can be so hard on parents.

It is important to do our best to take care of ourselves, so we can take care of our children.

I am so thankful for all of the things we have learned through parenting our kids.    I am thankful that our sweetie is back to regulation and love.  She never ceases to amaze me. I have no doubt in my mind that she is going to do wonderful things when she grows up. 

And then..... I tripped and broke my camera.


Karen said...

Could you elaborate more on what's in the "toolbox"? I'd love to give my son "tools" but he's not willing to do anything I ask when he's disregulated. And even if he's not, he gets very upset just talking about what we can do in various situations. When he's disregulated (as in, attacking/scratching/hitting/throwing/biting/hairpulling/kicking (person or items)/pinching) it feels like my choice (if I can't help him through it...very occasionally I can) are 1) restraining and having him take all his anger out on me or 2) having him wreck the house. If I walk away he will follow and attack me. He is (almost) 6.

I'm going to try the "magic mustache" and see if it will head some episodes off... :-)

Milena said...

They're called mandalas and I think t mat be a Tibetan word? The first ones I saw was like 15 years ago, when I saw tibetan monks made mandalas out of sand. It took several days, and when it was finished, they took a broom and it was all gone.... I can' t remember what the symbolism of it was, but I remember thinking it was beautiful.

Chris said...

Yes, elaborate on your tools please. I do know one thing rages at 2 yrs old are so much easier than rages at 10...

Christie M said...

The tool box is something I came up with when Anna was 5. You can make a real tangible one, and spend time making it and then putting "tools" into it. OR You can just have it be a pretend tool box where you pretend to open the lid on your head and put tools in and take them out.

Deep Breathing, rocking, swinging on the swing, using a koosh ball, pressure on arms, magic mustache, praying, drawing, are active tools.
Then there are the other tools like : Self Control, Love, Kindness, Gentleness, Patience, controlling your tongue.
Each of these is discussed as to what they mean and how they can help when we are angry or feeling dysregulated.
You can make it fun to create the tool box and put the tools in the box.
Then practice taking them out and using them WHILE regulated!

I am amazed at how well it works. Telling somebody "let's get a tool out" can make all the difference in self control and a melt down.

Mama needs tools too! And it works.

Aus said...

A quick story about how this works and where to "see" the victory's when they happen...

our youngest has a lot of fear that expresses as anger (isn't it all really?) - and at 5 still has a lot of control issues.

Tuesday night I cautioned him about walking on the back of the couch - if you do that you'll fall and get hurt - and not 15 seconds later as he fell I saved him from a face plant on the floor - but had to grab his arm on the way by to do that. He was scared and then went ballistic angry.

I sat on the floor and let him rage - kicking and screaming and swinging at me - I sat passively simply speaking gently - "you are OK" - "I love you" - "I'll wait for you to finish" - "I see you are angry" - "I understand you are afraid" - what ever.

And while all of his swings and claws and feet got "close" to connecting - I mean within an inch or two - and I was sitting with my legs crossed and hands passive and well within 'range' for him - not once did he try to connect.

That's a first - he DID exercise control - and that control was him trying NOT to hurt me...

Find the victory and celebrate and praise it.

hugs - aus and co.

Allison said...

For the first 2-1/2 years (starting at nearly five years old), our youngest was so severely dysregulated that there was little we could do to work with him on a toolbox. He physically attacked me every day, urinated everywhere, hoarded, ran off, started fires, almost never slept, then had constant night terrors when he did. He simply had no concept of what it would be like to be regulated. We had to find concrete ways to teach such an abstract concept. Even now, he is only able to use tools some of the time.

Our current toolbox contains things like jumping on his pogo stick; doing other sustained, rhythmic activity, like swinging, hiking, playing catch--all aimed at fundamental regulation; activities involving water, like fishing, swimming, skipping rocks, watering the flowers. We are sometimes able to use things like prayer, reciting scriptures about who my son is in Christ (my son is a Christian), and a little game we have called "The Turtle," in which one of my hands "crawls" slowly up from his foot to his head, making sensory soothing stops along the way--mostly on his head and face. He is not yet able to make use of more reason-based coping skills.

With my son, the biggest hurdle is in recognizing that his window of tolerance actually ends well before he starts to melt down. I have to affirmatively "feed the meter" every two-to-ten minutes to have any chance that he will be able to stay within the window. By the time he is visibly frustrated, it is too late to use the tools. He is also so dysregulated that a suggestion that he use one of the tools is typically met with a flat refusal. He nearly always wants to use the tools at times and in ways that appear to be aimed at avoiding school work, chores, or anything else he doesn't want to do. The challenge is to figure out when he needs to reregulate and when he is playing me.

I have learned to err on the side of letting him do the activity to reregulate. His need to manipulate and play me is rooted in his need to feel like he is not out-of-control. He needs to be as regulated as possible as often as possible. I cannot tell you how slippery and difficult a slope this is to navigate, though if you have a child like mine, you already know. He is so volatile that even after five years of attunement, I can't tell reliably what is going to set him off. The time lapse between the appearance of low-level cues and meltdown is often a matter of a few seconds. From there, things can get pretty scary for me as a parent. It is then that I realize how important it is for me to have my own toolbox to use to keep myself from reacting rather than responding in a helpful way to my son's dysregulation.

He is so much better than he was when he came to us. To some extent, I'm just used to working with him, but in just the past six months, we are seeing a lot of improvement in his ability to reregulate himself. There's no magic that I know of, but I do absolutely trust that our Savior knows and cares deeply about our son and that He will work his purposes out in His good time.

Anonymous said...

As Milena said, they're called Mandalas which is a Sanskrit (ancient Indian) word: http://en.wikipedia.org/wiki/Mandala
They have a spiritual component and serve to help center thoughts. :)

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