This is the first of a four part series that looks at ways anxiety might originate in each of our four brain systems. What is said here applies to any of the stress responses; I chose to spotlight anxiety because it its behaviors are the least understood as stress responses, yet they are the the most common in children.
Part 1: Anxiety from The Regulatory System (The Body)
Last month, I discussed the combination Red and Blue stress response known as Combo. Many of us spend a good deal of time in this state where our sympathetic and parasympathetic nervous systems are activated at the same time. Where the Red state might feel like annoyance, anger or rage, and the Blue like listlessness, melancholy, or depression, Combo can feel like nervousness, anxiety, or fear.
This month, we look at ways anxiety (the Combo state) in children can originate in the regulatory system of the brain, or more simply, by what is going awry in the body. Anxiety is responsible for a disrespectful attitude, control issues, and deliberate disobedience (both the sneaky type, and the type where the child looks you in the eye and calmly does exactly what you've just asked her not to do). Medical issues are easily overlooked as cause for such stress responses.
To illustrate this, I'll tell you about Sandy (a made-up name, but a real 7 year-old Caucasian girl). Sandy's mother fell in love with a woman we'll call Justina. Justina loved Sandy's mom back and wanted to marry her, but was not certain she wanted to take on little Sandy as a step-daughter.
Sandy has five official diagnoses: PTSD (Post-Traumatic Stress Disorder), RAD (Reactive Attachment Disorder), ADHD (Attention Deficit and Hyperactivity Disorder), Sleep Apnea and Enuresis. The part that made it especially hard for Justina was the RAD. Justina would enter the home, even after being on a trip away, and Sandy would not look up from what she was doing to return her greeting. When Justina would ask her not to do something, Sandy would do it anyway, seemingly to spite her. Sandy ignored Justina's bids for connection, but she would easily cozy up to strangers as though they were family.
Other symptoms of Sandy's included nightly screaming fits, gorging on food causing her to teeter on obesity, bed wetting at night and pants wetting at school, sneaky behaviors, tantrums, a learning disability in reading, and a language delay where her sentences came out grammatically mangled. Instead of He put the fork on the table, Sandy would say, "He putted fork on table."
Not long ago, Sandy's doctor referred Sandy to have her tonsils removed. She had enlarged adenoids and tonsils, causing an obstruction to her night breathing. This, the doctor believed, was causing the sleep apnea. The surgery was successful in many ways, it turns out. While the enlarged adenoids and tonsils caused the sleep apnea, the sleep apnea caused Sandy to fear for her life when she couldn't breathe. This was the cause of her night screaming. After her surgery, Sandy's many symptoms common to children undergoing trauma disappeared: She no longer wetted her pants at school. (She now sleeps so soundly at night that she continues to wet the bed occasionally.) She jumped up a grade level in reading and stopped making grammar mistakes, began to eat normally and lost weight, and (best of all for Justina) started to respond to non-primary caregivers in affectionate and cooperative ways.
Sandy's mom reports that Sandy is "a whole different kid," and Justina no longer has any reservations about melding her family with Sandy's. This is one striking example of where the regulatory system (a medical problem) was largely responsible for a child's challenges; despite a seemingly straightforward fix, however, it took years to understand how the cascade of symptoms came to be.
Other sources of anxiety-motivated behaviors from the regulatory system include unexplained stomach or head pain. It has not been uncommon for medical doctors to tell parents of children who frequently complain of stomach or headaches that the child is making it up to get attention. When a doctor cannot find a source of the pain after a great deal of cost and effort, an assumption is sometimes made that the pain is fabricated or imagined. Oftentimes, alternative and complimentary healthcare practitioners can identify causes that do not fit into a medical doctor's purvue.
Science has shown that anxiety springs from a sequela of compromised digestive, immune and hormonal responses incited by toxins in food, vaccinations, water sources, and other harmful environmental features. Cutting out allergens and avoiding artificial chemicals has made the difference for many children, but often, generations of epigenetic damage to children's genes can take years to reverse. The era of industrialized food that began in the 1950's took a couple of generations to show its effects , and the idea of trying to reverse them can feel overwhelming when there are few leads on where to begin.
It can be difficult to pin any one thing down. Sandy went through all kinds of diet experimentation before her solution was discovered. The best we can do is know that there are no bad children, only responses to stress; listen to our children and look for the causes of challenging behaviors; and provide them with the healthiest environment we can. That last one can be quite challenging, particularly when it comes to feeding children a healthy diet. The cost of time, money and personal energy it takes to prepare healthy meals that may get rejected anyway keeps many families in the the Western world from giving children the best possible diet, yet this is foundational to both physical and mental health. For help with an analysis on your time, financial, and energy drains that preclude healthy meals for you and your children, contact me for a consultation, or visit the free class in March: How to Get Your Kids to Eat Healthy Without Turning them Off to Good Food .
a neuro-relational look at anxiety in 4 parts
Part 1: Anxiety in the body
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in the classroom
for a student with anxiety
I was recently asked to send suggestions to a preschool for an upcoming IEP meeting. Here are, more or less, the suggestions I sent:
Social-Emotional IEP Goal Suggestions for a Child with Anxiety:
1) Regulation Throughout the Day
Given the use of four regulation strategies per hour, student will co-regulate with a staff member 80% of the time in order to maintain a sense of calm.
Strategies would first match and then counter student's regulation state (perhaps going from high to low intensity), and may include breathing exercises such as through MindYeti.com, GoNoodle.com, body awareness and movement games.
2) Regulation when Anxious
When student appears anxious (perseverative, panicky or disrespectful behaviors), staff will co-regulate with student by matching and validating emotion, stating a limit, then returning to matching and validating if needed. Staff will stay present with and focused on student until regulated, either trying a breathing exercise or remaining quiet and calm until student has settled down.
3) Problem Solving with Peers and Adults
Given coaching and list of problem-solving steps, student will follow steps of reflective problem-solving with adults and peers during 80% of altercations.
Steps would include these elements:
Stop and regulate before proceeding to solve a problem;
Recognize the feelings and points of view, first of self, then of others involved;
Identify a solution using a list of options such as Kelso’s Choice, the Wheel of Choice (Positive Discipline), or a list of ideas student works with staff to create (as described in Ross Greene's Lost at School);
Allow student to brainstorm and follow-through with ideas to repair any hurt feelings;
Collaborate with student to come up with a plan for the next time dysregulation occurs.
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1. Deep Nutrition: Why Your Genes Need Traditional Food by Catherine Shanahan, M.D.
2. First Bite: How We Learn to Eat by Bee Wilson