Guest blog: Linda Plowden, Occupational Therapist
It is well known that the effects of trauma on an individual are held in the body.
“In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.” - Bessel A. Van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
At Therapy Space Bristol, I regularly work with children who’ve experienced early trauma – our first port of call is always an assessment of the physical needs of the child arising from the impact of trauma on the child’s developing body and how this has a lasting impact on their ability to regulate their physical, emotional and attachment needs. Identifying difficulties in this way is essential to understanding the child.
Sensory attachment intervention can be helpful as a first step in supporting a young person to regulate their fight/flight/freeze/shutdown(submit) survival systems. It supports the person to develop co-regulation strategies between themselves and their important attachment figures and helps to disarm the child’s survival response both in school and at home. It also enables the parent/carer to regulate their own emotions. Within the Neurosequential model, this becomes the first foundation which is needed before moving onto other areas.
People often misunderstand emotions exhibited by dysregulated children and young people – it can be especially hard to attune to a student in the midst of a busy classroom, or in the middle of juggling duties at home, but it’s important to always attempt to respond to the underlying emotion rather than the expressed emotion.
For example:
Fear might be expressed as anger; risk-taking behaviour can stem from a desire to be rescued and protected, or in someone striving towards higher and higher achievement while dismissing ‘self; high levels of compliance/false positive affect can be a cover for underlying anger or resentment.
Emotional and physical regulation are intertwined, and supporting a young person to both recognise their emotional state, and develop their ability to up regulate (using alerting strategies) or down regulate (using calming strategies) as appropriate, is invaluable. I make use of the Zones of Regulation scheme with children and their carers in clinic and advise using this consistently both at home and at school.
Here are a few examples of where identifying appropriate sensory input can really support regulation:
If a child/young person is ANGRY – increase the level of input physically (e.g. climbing, heavy muscle work, wall push-ups, hanging off a trapeze). Proprioceptive input is the most regulating (deactivates fight/flight survival behaviours in most instances); also, use of chewy food (e.g. toffees, dried mangoes).
If a child/young person is ANXIOUS – crunchy foods and more regulating (e.g. biscuits, crisps, nuts, crackers)) and vestibular input is more calming (e.g. swinging in a hammock, rocking on a chair).
If a child/young person is in SHUTDOWN, then spicy foods can help, as well as fast active movements such as a quick run or set of star jumps.
Please do download a document we share through our work at Therapy space for lots of useful, practical ideas to support the children and young people you work with either at home or at school. This incorporates the five commonly known senses, plus proprioception and the vestibular system.
Linda Plowden is lead Occupational Therapist and Director of Therapy Space and has worked as a paediatric therapist since 1987. She has specialised in the last 10 years in working with attachment related difficulties linked to trauma.
Linda has co-written a set of books called “The Meltdown Kids”.
www.meltdownkids.co.uk/the-books which highlight sensory issues which are then often complicated by attachment issues. The books are excellent for 5 to 11 yrs old and are great addition to schools, families and other therapists to understand the child from a sensory perspective.
Follow her on Twitter @therapyspace and @meltdownkids