Polyvagal Informed Parenting

Applying the principles of Polyvagal Theory to parenting is substantially beneficial and empowering. 

The basis for this is that since Polyvagal Theory explains how our physiology responds in response to internal and external cues and stimuli, by embodying this understanding and the related principles in any domain of life, including parenting, we are able to work with our physiology.  As described above, whether or not we choose to acknowledge and understand these processes, they are continuously occurring.  By not embodying these principles we are, effectively, taking the chance that we may react or respond in a skillful and effective fashion.  In contrast, by fully embracing and implementing the polyvagal informed skills and strategies, we provide ourselves the greatest likelihood for performing in our role as humans and parents in the best possible fashion.  In addition these principles apply equally to those around us, including our children.  Recognizing and working with their physiology provides the best opportunity to develop connection with our children and optimize our ability to co-regulate them.

In addition to applying the polyvagal informed practices to ourselves, there are additional considerations in applying these skills and strategies to our parenting. It is important to recognize that just as the resilience of our nervous system is not determined by a lack of dysregulation, the relationships we have, including with our children, is not defined by a lack of conflict or rupture.  Rather, our relationships are better evaluated on the ability to rapidly and effectively repair any ruptures or conflicts which arise.  As we are all human, we will not always respond, react, and behave in the fashion we hope to.  There will be instances, including in our parenting, where we will behave suboptimally.  The recognition that, firstly, we are human and this is not abnormal or unexpected in combination with the acknowledgement that when this occurs, it the ensuing process of repair that is most important and the determinant of the resilience and quality of our relationship can provide substantial freedom and empowerment.

Application of Polyvagal Theory to parenting begins by accepting our physiological state, wherever it may be, as well as that of our child in the present moment.  It is important that this acknowledgement be without judgement or blame.  It is also helpful to recognize that our physiological states, as well as that of our child, can shift and change continuously in response to cues in the internal and external environment.  This makes our, and our child’s, physiological states dynamic in nature.  In addition, we can use the features of our own actions, behaviors, and physiology and that of our child as useful information to determine the current physiological state.  This is also done without criticism or judgement.  For instance, aggressive or attacking behavior should be seen as a reflection of physiological state, indicating that the individual feels under threat, rather than a conscious and deliberate decision.  Specifically, a child who has a tantrum in the grocery store is reflecting a sympathetic physiological state rather than an intent to cause commotion in the public place.  It is important to note that this understanding does not excuse poor behavior, rather it provides a useful explanation for it.

A polyvagal informed perspective to parenting will recognize that children, particularly when young, are not able to effectively and consistently self-regulate. 

Rather they rely upon their caregivers for co-regulation.  Through the process of providing cues of safety, thereby allowing for co-regulation, the child develops over time the ability to self-regulate.  In order to effectively co-regulate, it is important for the caregiver to shift their physiological state towards a ventral vagal predominant state.  This will result in the characteristic features of this physiology, thereby providing cues of safety to the child.  We are not able to project cues of safety and connection if we do not actually feel safe and connected.  It is not possible to fake this feeling.  The question then becomes, particularly in the midst of a challenging situation, for example the public tantrum, how do we shift our physiology to feel safe to be able to co-regulate.

The ability to find cues of safety in the midst of high demand and stressful situations results from two important skills.  The first is the ability to recognize without judgement our own physiological state.  The second is to employ skills and strategies that will shift our physiology in the desired direction.  For instance, during the public tantrum we may recognize that we are shifting into a sympathetic state.  Upon this identification, we can then turn to skills such as breathing, relaxation of facial muscles and posture, use of voice, relaxing our jaw, and finding cues of safety in our internal and external environment to help shift our physiology towards a ventral vagal state.  As we accomplish this, we will be able to co-regulate our child.  These skills are complex and require intentional and deliberate practice in order to develop a level of proficiency.

From the polyvagal informed perspective, it is important to remove cues of uncertainty, risk, and threat to the greatest extent possible from our child’s environment.  Of course, it is not possible to completely remove these potential cues.  For this reason it becomes important to recognize that when a child neurocepts such cues, there will be a predictable physiological shift which will then result in behaviors that can be anticipated.  Maintaining the greatest degree of consistency in parenting is important so that the child is able to predict responses and reactions.  Uncertainty can be a significant cue leading to mobilization towards sympathetic states.  In addition, consequences for behaviors should be carefully considered and chosen so as to avoid introduction of additional cues of uncertainty, risk, and threat.

Continue to follow @Parentsuitcase on Instagram and Pinterest and a special thank you to our collaborative expert content contributor Dr. Davidson MD, MHSC, FRSCS

#polyvagaltheory #positiveparenting #peacefulparenting #polyvagal #polyvagalparenting

When a child is diagnosed with cancer: Part II

Treating a child with cancer does not start and stop with the medical interventions.

There must also be careful consideration & management regarding the emotional and psychological health of the child, the parents, other siblings (if applicable), and the family in general. It is important to maintain as normal a routine as possible for the child, including schooling, time with friends, and enjoyment of other activities. While this may be disrupted if inpatient treatment is necessary & during recovery from treatment, the more the usual routine can be followed, the better for the overall health & wellbeing of the child and family. Of course, if modification is necessary for comfort, that is completely understandable. You have to do what works best for you and your family, and sometimes that means being flexible and adapting as needed.

What are some ways to create stability in routine?

1. Reading familiar books, maintaining a similar bedtime rouotine

2. Eating a family meal together

3. Doing something creative or something that brings you joy, particularly an activity that requires minimal effort

4. Prioritizing rest when needed

5. Working on school activities together (if applicable)

6. Finding ways to remain social, even if it can only be virtual (based on current needs & recommendations from healthcare team)

7. Scheduling virtual calls with school friends

Involvement of child life specialists can be very beneficial in this regard. This service is frequently available through pediatric specialty centers. Child life specialists work with children & families to help them cope with some of the stressors they may experience while being treated for cancer. They help families by providing different coping strategies while undergoing different medical procedures, preparing mentally for various tests / diagnostic procedures, providing parent education and ways to be supportive & educated on such procedures, developing coping tools for sibling support, etc.

There are many resources that can assist families, particularly during the treatment phase of childhood cancers. Connecting with other families with children with similar cancer types and treatments is critical to increase support for the family. Obtaining financial resources regarding travel and accommodations, if needed, is also available through many organizations and should be explored. It is also important to obtain reputable information from such sites as ‘cancer.net’, ‘cancercare.org’, ‘childrenscancer.org’, as well as sites dedicated to the specific type of cancer. If you follow me on Instagram, I recently covered this topic and offered some resources specifically for childhood cancer support here:

1. Comfort items for hospital stays

2. Parental Health & Childhood Cancer

3. “My child just received a cancer diagnosis, what is my first step?”

4. How to support a family whose child was diagnosed with cancer

5. National Childhood Cancer Awareness Month

In anticipation of upcoming appointments, it can be helpful for parents to put together a list of questions to ask the treating providers. These 6 questions can include (and are not limited to) the following:

1. Is the diagnosis correct and how do we know? This question is not intended to offend the treating provider- the intention is to provide more insight on clinical findings, diagnostic results, pathology findings, etc. The more informed we can be as parents, the more we can understand the details of the child’s care plan, collaborative next steps, and how to best navigate it.

2. Can we have a second opinion? Again- this question is not intended to offend the treating provider. Having a second opinion can also help the family to feel more confident and empowered in the care that they are receiving and to further confirm the stage of the disease & diagnosis. Also, some centers may offer more advanced treatment options.

3. What are the treatment options and the associated advantages & disadvantages? The discussion of quality of life is a major consideration here. Being informed on the possible advantages & disadvantages of certain treatments allows you to feel more empowered while making such personal family decisions. It is important to consider and discuss the goals of treatment, which includes not only treating the cancer itself but maintaining comfort, symptom control, and quality of life.

4. Is the treating provider a pediatric specialist or is a referral to a pediatric specialist necessary?

5. What resources and services are available to help with support for the family and finances? Here is a list of resources for additional financial support: financial assistance for teens & children

6. How do we maintain as normal a routine as possible during treatment?

By considering the factors discussed above, the unimaginable difficulty of treating childhood cancer can be made somewhat more manageable for the child and family. For more information on this topic, please visit @ParentSuitcase on Instagram.

#childhoodcancer #cancercaresupport #childhoodcancerawareness #parentsupport #parentingresources

Disclaimer: The information on this platform is not intended or implied to be a substitute for personal professional medical advice, diagnosis, or treatment. All platform content including text, graphics, images, and information is for general information purposes only & does not replace clinical consultation with your own doctor/mental health professional.

When a child is diagnosed with cancer: Part I

When a child is diagnosed with cancer, there can be an understandably strong, emotional reaction from parents and family.  There are several ways that this extremely difficult situation can be assisted, including obtaining information, gathering resources, and asking questions.  Part I of this blog provides an overview of these elements to create a foundation for parents and families who may be navigating the challenges and emotions of having a child with cancer.

Childhood cancer may share some aspects with adult cancers, however there are also many notable differences.  There are approximately 10,470 new cases of cancer amongst children younger than 15 each year in the United States.*  These cancers account for numerous types- some are also seen amongst adults and others are specific to, or more frequent in, children.  The majority of instances of cancer amongst children are not related to environmental or lifestyle factors, as is much more frequent in adults.

The diagnosis & management of childhood cancer is typically more specialized than it is amongst adults.  While many forms of cancer in adults are treated in both community and specialty centers, the majority of childhood cancers are treated in specialized pediatric settings.  This leads to increased challenges in access to care amongst families who do not live in proximity to major medical centers, where most pediatric centers are located.  Treatment methods may also differ amongst children in comparison to adults.  In part, this is the result of childhood-specific factors, such as growth.  In order to preserve growth, treatment strategies amongst children may be substantially different than they would be for adults.

Another important difference between childhood and adult cancer is the prognosis.  Amongst all types of cancer in children, the overall 5 year survival is approximately 85%.  This represents an improved prognosis compared to adults.  It is important to consider, however, that this estimated survival is amongst all types of cancer and, unfortunately, there are cancer types that are associated with a lower 5 year survival.  The prognosis is dependent upon the type and stage of the cancer at the time of diagnosis, but typically there is a better survival rate amongst children with cancer than adults.

Parents and caregivers of children diagnosed with cancer are understandably presented with several significant challenges.  There is the initial shock of the diagnosis and obvious concerns for the wellbeing and health of their child / loved one.  In order to support themselves and those around them, there are several aspects that parents can emphasize. 

• They should obtain as much information as possible, both from the treating providers and through their own research.  Understanding as much of the applicable medical information as possible is important in order to make informed treatment decisions as well as help answer questions that the child and other family members may ask. 

• By obtaining relevant and accurate information, anxiety about the diagnosis, treatment, and outcome can be reduced.  It is crucial that parents understand as much as possible about the diagnosis and treatment options. 

• In order to make informed decisions, it is important to understand not only what is recommended by the treating provider, but also other appropriate treatment options.  This may require obtaining a second opinion, which should not be a hesitation.  It is crucial that pediatric specific specialists be involved with treatment planning and provision of as much treatment as possible. 

• Given logistical considerations, it may not be possible for every child to be treated in a pediatric specific center.  In such cases, obtaining recommendations from a pediatric cancer specialist that can be implemented closer to home should be considered.

Please follow along for Part II: Childhood cancer treatment & other considerations

Follow @ParentSuitcase on Instagram and Pinterest

#parent #childhoodcancer #parentsupport

Disclaimer: The information on this platform is not intended or implied to be a substitute for personal professional medical advice, diagnosis, or treatment. All platform content including text, graphics, images, and information is for general information purposes only & does not replace clinical consultation with your own doctor/mental health professional.

Sources:

*Cancer.org