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.

Introduction into Polyvagal Theory

Have you ever been stuck in traffic? Has your child ever had a tantrum in public?

We have all been in these situations many times. When these circumstances occur, are there days when you respond in a calm and constructive fashion while at other times become frustrated, aggravated, or felt like giving up? Of course, we have all experienced these feelings and reactions to these situations at one time or another.

Why does this occur?

The situations are the same, or at least very similar, so why might we have such a different responses? The answer to this important question lies in the function of our nervous system. Specifically, the explanation relates to how our nervous system is continuously scanning our internal & external environment for cues of safety and cues or risk or uncertainty. While this may seem complex, an understanding of Polyvagal Theory makes this more accessible than it may appear at first.

The concepts of Polyvagal Theory are becoming more commonly discussed and encountered within all areas of life. While the more frequent discussion of this theory may be relatively recent, it was first described by Stephen Porges, PhD in the mid 1990’s. This theory is evidence-driven and describes how our nervous system, specifically the autonomic component, functions in response to the cues and stimuli we continuously encounter in our internal and external environments. The theory further explains how our nervous system uses this information to direct responses across our entire body, including our thoughts, muscle tension, posture, hearing, voice, breathing, and digestive functioning.

The basis for these widespread effects is our vagus nerve and its connections to many aspects of our physiology. The true power of this theory lies not only in its explanation of how we experience the events in our life, but through the provision of skills and strategies that we can implement to direct our physiology in ways that are most supportive of what we are trying to accomplish in a particular situation.

Polyvagal Theory is based on details of our neurophysiology which are common to all social mammals.

There are specific core principles which are important to understand in order to apply the details of the theory in our lives. These include the physiological states determined by our nervous system, the process of neuroception, the social engagement system, and the concept of our physiological state as an intervening variable. With an understanding of these concepts, it is possible to embody the principles of the theory and improve our lives as well as the lives of those around us.

The physiological states determined through Polyvagal Theory are ventral vagal, sympathetic, and dorsal vagal.

These states are evolutionarily determined with the ventral vagal state being most recent. It is important to understand the characteristics of each state in order to be able to identify our state at any given time and learn to shift our state towards that which we choose.

The ventral vagal state is one in which we are grounded and connected to ourselves and others. Our thinking tends to be more oriented towards curiosity, being open to possibilities, and optimistic. Our muscle tone is relaxed, our jaw and facial features are softened, there is range & prosody in our voice, and our posture is open. Our breathing is deeper and slower, typically in conjunction with a diaphragmatic pattern. There is increased variability in the time between our heartbeats, referred to as heart rate variability. Our heart rate is increased during inhalation and decreases during exhalation, referred to as respiratory sinus arrhythmia. This state is considered as a state of safety and connection, both to ourselves and others. It is within this state that our body is in homeostasis and is able to recover and restore itself.

The sympathetic state is the widely known as the fight or flight response. This occurs in response to a perceived risk or threat. This state is characterized by anxious, angry, or aggressive thoughts. Our muscle tension and jaw tighten. The prosody and pitch of our voice loses its fluctuation. Our posture becomes more closed. Our breathing pattern typically becomes faster, more shallow, and centered in the chest. Heart rate variability is decreased.

The dorsal vagal shutdown state is best described by the response of the body to an overwhelming threat in which we try to conserve as much resource as possible by hiding and, at the extreme, feigning death. Our muscle tone is decreased. Our facial features become flat. Our breathing slows and becomes shallow. Our thoughts are consistent with giving up and hiding.

While each of these physiological states are appropriate and adaptive in certain circumstances, we are best able to express our truest and fullest potential as well as problem solve and perform to our highest capacity in either a ventral vagal state or a blended ventral vagal-sympathetic state. Due to this, the states can be organized in a hierarchy with the ventral vagal state at the top, followed by the sympathetic state, and the dorsal vagal state. It is important to note that we both descend and ascend this hierarchy through each state. In practice, this means that in order to ascend from a dorsal vagal state, we must first reach a sympathetic state, if even only briefly, before reaching a ventral vagal state.

The next foundational principle of Polyvagal Theory is neuroception.

This is the process by which are nervous system essentially scans our internal and external environments to detect cues of either safety and connection or cues of uncertainty, risk, and threat. This process occurs continuously and beneath conscious awareness. On the basis of whether there is a preponderance of cues of safety and connection or uncertainty, risk, and threat our physiology will shift on the hierarchy. If the balance of cues is in favor of safety and connection our body moves towards a ventral vagal state. On the other hand, if the balance is towards uncertainty, risk or threat our physiology moves first towards a sympathetic state and, if there are further cues of risk and threat or the initial threat is not resolved, then into a dorsal vagal state. It is important to emphasize that neuroception occurs whether or not we choose to acknowledge the process and develop skills to shift our states towards our chosen physiology. This process occurs beneath conscious awareness and, as such, it is not our choice to shift towards sympathetic and/or dorsal vagal states and to take on the characteristics of those

states.

The next foundational principle of the theory which will be discussed is the social engagement system.

This describes the connection from our brainstem to the muscles and organs in our face and chest through various cranial nerves. Many of the characteristics of the physiological states described above specifically reference the head and neck region. The resulting changes in facial features, voice, muscle tone, posture, and breathing not only reflect and impact our own physiological state, but also provide cues to those individuals around us. Through the process of neuroception, those individuals will then determine whether or not we are providing cues of safety and connection or cues of uncertainty, risk, and threat. It is through this social engagement system that we are able to influence the physiological state of ourselves and those around us. If we truly feel safe and connected in our body, we are able to project these cues externally through the social engagement system and this will allow those around us to shift their physiology towards a ventral vagal state. This process is termed co-regulation. The ability to shift our own physiology towards a ventral vagal state is termed self-regulation. Typically, it is not possible initially for younger children to self-regulate. Rather their future ability to self-regulate is dependent upon co-regulation from their caregivers when they are young.

The final foundational aspect for consideration is the principle of physiological state as an intervening variable.

Functionally, this corresponds to the understanding that our current physiological state will influence the process of neuroception such that a particular cue may be neurocepted as a cue of safety and connection if we are in a ventral vagal state but may be neurocepted as a cue of uncertainty, risk, or even threat if we are in a sympathetic or dorsal vagal state. This principles informs our everyday experience of noticing different reactions to very similar events, such as the traffic and public tantrum examples, described above.

In response to cues of uncertainty, risk, and threat both internally and externally, we have seen how our physiology can shift towards sympathetic and dorsal vagal states. This process is not in and of itself maladaptive. Rather it is the normal, predictable, and expected response of our nervous system in response to these cues. By extension, the hallmark of a healthy, resilient, and adaptive nervous system is not the lack of dysregulation towards these states. Rather, the defining feature of resilience within our nervous system is our ability to restore stability following periods of dysregulation. In particular, it is our capacity to efficiently and effectively self-regulate.

Follow along to read more about Polyvagal Theory and Parenting in this next blog!

Blog contribution from Darin Davidson MD, MHSC, FRCSC Polyvagal Informed Coaching & Concierge Care

Follow on social media: @ParentSuitcase on Instagram and Pinterest

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 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