Mental health counsellor and DIR Expert Training Leader, Gene Christian joins us from Spokane, Washington this week to share how adults with extreme developmental differences can benefit from DIR/Floortime. I was introduced to Gene in ICDL‘s Floortime for Adults course. His description of how to bring out the early social-emotional capacities was really enlightening to my experience having only previously considered Floortime with children. I hope you’ll tune in to hear from Gene’s wisdom and experience.

From Dysregulation to Intent with Gene Christian

by Affect Autism

Gene began studying under Dr. Stanley Greenspan in 2001. Previously he had been using positive behavioural support with adults who had behavioural issues and they adapted DIR/Floortime in a respectful way. The adults he worked with were unable to show intent in a way that was clear to their caregivers. Dr. Greenspan always emphasized that without the ability to interact with other people and co-regulate with others, we are subject to inner emotions that we surely don’t understand and can’t control, which is what people call behaviour problems.

Facilitating development

To facilitate development, Gene’s focus is on the first four Functional Emotional Developmental Capacities (FEDCs) whether it’s a baby or a 45-year-old man. Today Gene’s focus is about adults who are isolated. They might have been in an institutional setting for years and never had a real meaningful interaction with anyone as caregivers come and go to feed or change them, etc. These are people who are locked in their own sensory processing systems. From what he has seen, this approach really helps people feel better about their lives and their environments because they begin to use Relationships

Gene gives a fantastic description of the functional emotional developmental capacities describing how at engagement, a typically developing baby “zaps into the mother’s eyes“. This is pre-verbal gestural signalling and non-verbal communication that sensory differences can prevent from taking place. Autistic individuals may not zap in and make that critical connection that starts forming the sense of self. So how can we make that first connection? Gene says it is always about following that person’s lead.

Gene describes how emotional isolation really creates turbulent emotions and the person lives locked in a world which results in what we tend to call problem behaviour. But in the engagement period there’s two parties to a relationship which moves into intent. The primary caregiver responds to the baby as much as the baby responds to the primary caregiver, in typical development. You don’t get regulated without using other people when you’re learning initially, then when we’re older we learn our own ways to self-regulate. Gradually we become intentional because we delight in the power of being an active participant in what’s going on.

As we move through engagement and back-and-forth interactions, we reach the fourth capacity where all of these things we have developed in the first three capacities helps us be able to stop when we see signals from others indicating our actions might not be socially appropriate in that moment. This fourth capacity is about practicing the ability to solve problems with others, having a sensitivity to other people, empathizing with others through emotional signalling, and developing a sense of self as we solve social problems when we come up against the reality principle, Gene says.

We have to have the ability to conceptualize ourselves and the others around us, which we can’t do well without the thorough fourth capacity which means interacting in a calm fashion through frustration and conflict and all the things the world throws at us. These skills flower in the fifth capacity when we symbolize in our own head ‘me’ and ‘you’ and other things in the world and we then tie together ideas in the sixth capacity.

The biggest mistake we make with people in these first four capacities is trying to get them to do things that are not yet in their repetoire that they’re not developmentally prepared for yet.

Gene Christian

DIR/Floortime

We can counter the sense of isolation using Floortime with non-verbal adults who have extreme developmental differences. Severe processing issues prevent them from entering these interactions so we want to work on this, which is hard when they struggle with regulation. But we can begin by mirroring what they do, being mildly playful, and creating little problems appropriate to where the client is developmentally. For example, if I’m slapping hands with somebody I might miss their hand one time entirely. This is the level of obstruction and nothing more.

Connection can be slow, but once you’re consistently able to engage in 10 circles of communication in a row on a regular basis, it seems that people can experience real shared regulation, engagement and beyond. Our goal with circles of communication is to get the client to open the circles, or initiation of back-and-forth interactions. Too frequently we expect more of people than they’re able to do developmentally and we tend to want to focus on organizational, analytical, linguistically-based thinking when these folks aren’t in that world yet. They’re still in their own inner world.

When we work on getting the back-and-forth capacity, we of course want the client to initiate but even if we clap with them, we might stick our hand in between their clap. They might get really frustrated and if so, we respect that and back off. But they may get really playful and close that circle by moving their hands up higher, or grabbing our hand. This is where we are really challenged in our DIR world. How do we get people who are struggling in the first four capacities to begin to open circles.

The affinity of a relationship can often pull a client in to interactions, but it’s really hard to get administrators to understand this because this is all ‘pre-verbal stuff’. We don’t remember navigating the first four capacities ourselves because we don’t have the symbolic strength to label and file them yet at that developmental level.

Gene Christian

Gene Christian on IQ Tests

I really question the idea of even beginning to think about the cognitive evaluation of people who are still struggling with the first four capacities. They’re unable yet to respond to questions, they’re not able to go through all of the little pieces of any kind of IQ test and so we jump to the understanding that, “Oops! Cognvitively they’re really challenged.” Well, they’re really challenged by their processing system but we really don’t understand what’s going on inside. They might have a whole sense of how the world functions and their potential is something we just don’t yet know.

Intentional

Once engagement begins to happen, the person will naturally move in to being intentional: Realizing that they can impact the behaviour of other people with their own behaviour.

  

Fully complete as you are

Gene refers to Martin Buber’s “I Thou” way: “You are a really important person, you intrigue me and I want to learn what I can about you.” and about Maslow’s seeing people as being whole, complete, and perfect in and of itself. “The only way as folks will really change is if we treat them as being fully complete as they are.

Respectful boundaries

Greenspan always talked about giving people control and respecting their boundaries. The adults we’re discussing have been handed demands of various kinds that they really don’t understand day in and day out. Getting past that and realizing they’re safe and that you’re not going to interfere with their plan, which might just be a regulatory motor plan (such as a stim), builds the trust. You’re not there to make them do anything.

  

Following their timeline

One of the phrases Gene often has to counter is, “I really want to move him to the next capacity.” Gene says, “No. You are not going to move him to the next capacity. You’re going to be with him and engage in the Floortime and watch him do his own moving at his own pace.”

Developing a sense of self through our interaction with others

Without navigating those first four capacities effectively, the emotional issues that we didn’t resolve in the fourth capacity come back to haunt us. How many of you have seen a person get angry and just leave a conversation because they can’t do it anymore? We want to see a person be able to navigate all of these emotions while continuing to interact. None of us truly masters the fourth capacity, but it really leads into the fifth capacity, our sense of self. When we realize that we all develop and go through these stages, putting ourselves in their shoes, we can really begin to try to understand what another person goes through.

The fourth capacity is about learning to become a human being in a pre-verbal way. it’s in the fourth capacity that we learn to not walk up to a group of people and start talking about our favourite thing without checking in on them. Checking in on them is a pre-verbal thing that we have. You might walk up to a group and want to make a joke, but then you can access that something serious is going on so you decide not to bring it up because it wouldn’t be appropriate. 

We really learn to get very sophisticated when we’re navigating the fourth capacity in terms of our emotions when we interact and engage with other people. That’s when we really learn to modulate. Negative pre-verbal signalling is getting mad and melting down when we enter the fourth capacity. But as we begin to develop the ability to sense it, we begin to develop more control over how we modulate our expressions of emotion, and that is really a fourth capacity function. It is about compromise.

Decrease in behavioural outbursts with Floortime

Gene shared with us very vivid examples of the types of problem behaviours he has witnessed from adults trapped in their own sensory systems and how these behaviours decreased with a DIR approach because the adults moved from dysregulation to intent when they were finally able to communicate with others in the pre-verbal ways described above. Please see the video podcast for the graphical representations of his team’s data.

Thank you to Gene Christian for taking the time to discuss his presentation about moving adults from dysregulation to intent using DIR/Floortime. If you have any comments, questions or stories to share about today’s podcast, please consider putting them in the Comments section below. Also please consider sharing this post on Facebook or Twitter and telling a friend who could benefit from Gene Christian’s experiences.

Until next time… here’s to affecting autism through play!

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