About to Have a Parent Tantrum? Polyvagal-informed practices to help.

Another scenario common to all parents is the feeling of an impending or the presence of an actual parent tantrum.

We have all been there. We become so frustrated, so aggravated with whatever the current situation may be that we become angry, we may raise our voice, we may say or think things we would otherwise never contemplate. In essence, this is the parent equivalent of the classic toddler temper tantrum. How do we manage such a situation?

First, it is important to always remember that we are all human. Our physiology all works the same way. No matter how good our intentions, or how much we practice skills and strategies to manage our physiology, we are still human. As humans, we will not always get things right, we will not always show up or respond the way we would like and we may have reactions, even tantrums, that do not reflect our true nature or desires. This recognition is a component of the non-judgmental acknowledgement of our physiological state.

The first step in managing a parent tantrum, like with all situations, is the acknowledgement of the current physiological state without judgment or criticism. It is important to recall that our response to internal and external cues occurs, via neuroception, beneath conscious awareness and is not deliberately decided. As such, we did not choose to react to a given internal or external cue in a fashion that led to the tantrum. This does not reflect our intentions, values, or how we would like to respond to the stimulus. This is an unconscious reaction mediated by our nervous system.

While the manner in which we neurocept a given stimulus is not under our control, what happens next can be better controlled. If we are able, through training our nervous system, to rapidly identify the shift in our physiology, we are then able to implement the appropriate skills to shift our physiology towards the desired state. Using this concept, we can illustrate the process for the parent tantrum. In response to a particular internal or external stimulus, we have neurocepted a cue of uncertainly, risk, or threat. The resulting physiological response is a shift towards a sympathetic state. The nature and characteristics of a tantrum correspond very closely to this physiological state.

Following identification of the present sympathetic state, we can then implement our skills and strategies to shift our state towards a ventral vagal state through breathing, thinking, relaxing muscle tone, opening posture, and use of our voice. It is important to note that developing a wide array of skills and strategies is ideal as the preferred skill or strategy may vary at different times or under changing circumstances.

In order to provide the greatest opportunity for success in managing our physiology, it is therefore preferable to have many different tools in our proverbial toolbox. As with the case of shifting away from a dorsal vagal state, each successive instance in which we are able to modify our physiology in response to stimuli strengthens our ability to not only do so in the future but also to tolerate increased levels of stress without associated unwanted shifts in our physiology.

As can be appreciated from the above description, there is substantial empowerment available through embodiment of the skills and strategies based upon Polyvagal Theory.

By understanding our physiology and training the ability to manage our physiological state, we are better positioned to be at our best for ourselves and those around us. This approach respects and works with our physiology and does not attempt to overcome or override it. In so doing, we are best able to express our fullest potential in alignment with what we find most important and value most.

REFERENCES

Dana, D. Polyvagal Exercises for Safety and Connection: 50 Client-centered Practices. New York: W.W. Norton & Company; 2020.

Dana, D. Anchored: How to Befriend Your Nervous System Using Polyvagal Theory. Boulder, Colorado: Sounds True, 2021.

Delahooke, M. Brain-Body Parenting: How to Stop Managing Behavior and Start Raising Joyful, Resilient Kids. New York: HarperCollins, 2022.

Porges, SW. Polyvagal Safety: Attachment, Communication, Self-Regulation. New York: W.W. Norton & Company; 2021.

Porges, SW. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation. New York: W.W. Norton & Company; 2011.

Porges, SW. Presidential Address, 1994. Orienting in a Defensive World: Mammalian Modifications of our Evolutionary Heritage. A Polyvagal Thoery. Psychophysiol 1995; 32: 301-318.

A special thank you to Dr. Darin Davidson MD for his collaborative interview on Polyvagal Informed Practices.

Nervous System Regulation & Parent Health: Part 1 of 2

Developing the ability to regulate our nervous system is crucial to promote our health, wellbeing, and be at our best in any role in life, particularly parenting. 

Recovery and restoration are essential processes in the promotion of health and wellbeing.  Ventral vagal activation is necessary in order for this to occur.  In addition, a relative lack of ventral vagal tone and increased and chronic sympathetic and dorsal vagal activation have been associated with several physical and mental health conditions, including cardiovascular ailments, impaired immune function, chronic inflammation, anxiety, and depression.

In order to best maintain and enhance our health, an intentional recovery routine is important. 

This includes mindset training, sufficient quantity and duration of sleep, adequate nutrition and hydration, and physical activity.  While it can be challenging, if not impossible, to fully prioritize each of these elements, particularly with young children, it is important to optimize each to the extent possible.  These elements each function to promote ventral vagal activation leading, at least in part, to recovery and restoration.  When multiple of these factors can be combined, the effect is greater than the sum of its parts.  Another important consideration is specific training of mind-based and body-based skills to promote vagal efficiency, thereby further improving ventral vagal activation.

This process is proactive in nature and is at its greatest positive impact when integrated within a daily routine. 

In doing so we not only benefit from the regular effects of ventral vagal activation but also increase our ability to access these strategies and their effects when most in need, specifically during high stakes situations.  In order to best be able to be of service to others, our own health and wellbeing must be optimized.  This is a necessary factor in being the best version of ourselves in any, and all, situations.

Follow this blog for Part 2 on Nervous System Regulation & Parent Health! Visit @parentsuitcase on Instagram and Pinterest! Thank you to our collaborator, Dr. Darin Davidson MD MD, MHSC, FRCSC on this topic. Dr Davidson is a Polyvagal-Informed Coach and Concierge Care Physician who works with professionals both virtually and in-person.

REFERENCES

Dana, D.  Polyvagal Exercises for Safety and Connection: 50 Client-centered Practices.  New York: W.W. Norton & Company; 2020.

Dana, D.  Anchored: How to Befriend Your Nervous System Using Polyvagal Theory.  Boulder, Colorado: Sounds True, 2021.

Delahooke, M.  Brain-Body Parenting: How to Stop Managing Behavior and Start Raising Joyful, Resilient Kids.  New York: HarperCollins, 2022.

Porges, SW.  Polyvagal Safety: Attachment, Communication, Self-Regulation.  New York: W.W. Norton & Company; 2021.

Porges, SW.  The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation.  New York: W.W. Norton & Company; 2011.

Porges, SW.  Presidential Address, 1994.  Orienting in a Defensive World: Mammalian Modifications of our Evolutionary Heritage.  A Polyvagal Thoery.  Psychophysiol 1995; 32: 301-318.

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.