This Week’s Guest
Returning guest, DIR Expert Training Leader and Licensed Professional Counsellor, Mike Fields, joins us this week to discuss aggression. We’ll cover praxis, regulation and co-regulation, neuroception (i.e., the body scanning the environment for safety), limit setting, self-directed aggression, trauma, and more, across age groups. Aggression is one thing when your child is a toddler, but can be a very scary thing when your child gets big. DIR folks will talk about a child not feeling safe, but it can almost sound trite when parents, of course, always want to do what’s best for their child and don’t understand why their child isn’t feeling safe.
Empathy, Compassion, and Safety
Mike says let’s start with empathy and wanting to understand, and accepting that we don’t have control over everything and can’t always make things better. We do the best we can. Have compassion for yourself and for others. Next, Mike asks what the definition of aggression is? He reads the dictionary definition and wonders if “anger, hostility, and rage” forgets about fear and ‘fight or flight’? Aggression can be big and intense. It really is that ‘fight’ response to feeling threatened and we know that although the first Functional Emotional Developmental Capacity (FEDC) is about regulation, FEDC zero is really about safety.
Safety is one of those absolutes, Mike says. Floortime includes following the lead, negotiating, and working through solving problems interactively. You can’t really Floortime safety in the moment. If you go on a roller coaster and you’re going up the hill, you can plan and get ready, but once it goes over and down, all you can do is hang on. Sometimes when there’s aggression, there’s just hanging on to make it through and limit harm. Part of that is anticipating, planning for and trying to set up.
There are safe ways to physically restrain if it gets to an extreme, and Mike encourages anyone facing repeated physical violence to get training on that. We want to anticipate by setting up the environment so that if you have a child who throws, you have bean bags laying around rather than hard objects that can hurt someone if thrown, for instance, Mike shares. You can have limits in Floortime, Mike says. It’s not just letting kids do whatever they want to do. “Bring it back to the model“, ICDL’s CEO says at the training leader meetings, Mike says.
If someone is dysregulated, you’re back at ‘FEDC zero’, then FEDC 1 is where we co-regulate. Sometimes you can give deep pressure. Other kids can’t handle any sensory input at all when they’re dysregulated. This is where Relationship is so important, Mike explains. The parents have the best relationship with their child, so Mike will step back and coach the parents asking, “What’s the least you can do to calm the child?” for an overwhelmed child.
If they’re bashing their head, they might put their hand down so the child’s head bashes into their hand instead of onto the floor, and it’s the parents who have to do that, Mike says. It’s scary for both the child and the parents, Mike continues. It’s about finding out what is soothing to the child, what gets them more aroused, and trying to get them back into a place of safety. It’s about their Individual differences.
A Child’s Sense of Safety
Autistic adults have told us what didn’t feel safe to them. I was listening to a Learn Play Thrive podcast on PICA and eating challenges where the guest discussed how she didn’t feel safe so she couldn’t eat, but when she felt safe, she would eat. The individual’s sense of safety can be so misunderstood by parents who don’t understand why their child would feel unsafe in their comfort zone at home. But maybe it’s a sensory discomfort–maybe the clothes they’re wearing are irritating their skin, maybe the temperature is too hot or cold, maybe there is a frequency of noise that is aversive to them, etc.
Dr. Stephen Porges and Dr. Mona Delahooke write about neuroception–how our brain assesses if something is a threat or not, Mike explains. We connect through the world through our senses. The brain’s job is about defense, Mike says, so when we sense something, we can habituate to it if it’s a familiar pattern. Your brain tells us if something is a potential threat. So we are concerned with what patterns our brains or bodies recognize, Mike explains. Some of our kids are under or over responsive to sensory input.
Everything is Praxis
It can be a pattern that we don’t notice something until it’s too late, Mike continues. If our praxis is not great, it might be hard for us to predict what’s coming. Motor planning is the start of everything, Mike says, but he’s a counsellor so he’s focusing more on ideas and emotions. Praxis is everything from having an idea to how we execute the idea. This includes that if something goes wrong, how do we change that idea?
I was speaking with Dr. John Carpente preparing for our ICDL Conference presentation and showed him a video of my son playing. John noticed that my son has many compartmentalized ideas and it hints at motor planning challenges. He suggested a next step is to figure out how we bridge ideas together and help him sequence in play. In the 4th capacity is where children begin to sequence and figure out that there is a beginning, a middle, and an end to a story and this progresses through ideation into the 5th capacity and the 6th capacity.
Mike says that this is ideation, which is part of it. Motor planning is physical because we can see if we don’t use enough pressure with our hand to lift a glass of water, it falls and breaks so we get immediate feedback, Mike explains. But how do we do that with ideas or feelings, Mike asks? If I say or do something, how are you going to react? When we deal with ideas, it’s a lot more complicated. It’s abstract and we don’t get a lot of feedback, Mike says. We might say something and expect a response, but when we don’t get that response, we can’t see why.
Feelings and emotions are even more difficult than dealing with symbolic ideas such as sounds that a letter makes. They have a sensory component. When we feel angry, for instance, we have a sensation in our body, and we may or may not connect the two. And we can’t express it, I add. Our child can’t say, “I feel sad today because the change of seasons reminds me of the time you went back to work after your maternity leave ended and I missed you so I am expecting some extra love and attention today.” Nobody will ever say that, and may not even recognize it themselves, so we have to make our best guess.
Another tricky part of this, Mike continues, is that we want to know what’s happening, but we can’t always know. Mike used to be a software engineer and he gave us the metaphor of the ‘blackbox’. He would program in some input and get back some output. All he knew is that he sent something and it sent back something else. It’s about being ok with the unknown, Mike states. In the DIR 202 course Mike teaches, he talks about how to get comfortable with being uncomfortable.
When things are going as expected, we will be calm and regulated. But when things don’t go as planned, we get dysregulated and we have sensations and feelings. Maybe we sweat or our heart rate increases. We then are less able to accurately predict what’s going to happen. And being regulated is the first Functional Emotional Developmental Capacity (FEDC), whereas language is at the 5th capacity and logical thinking at the 6th. Our neuroception tells us that there’s a threat. We may or may not know what that is, so our brain gives our body a sensation. How do we release this tension in our body? Some may freeze or flee. Others will fight to release the tension.
When you’re shaking that bottom layer, everything gets weaker.
I asked Mike about Executive Functioning and Praxis. He says that Executive Functioning is how we manage Praxis. We have to bring our facilities to bear on the problem, he explains. You’re aware you need to do something, but then something happens that interrupts the steps, so you leave it. It’s about an execution of praxis. Mike believes that everything is praxis. It’s one of the keys to understanding what’s happening around us, to predict what’s going to happen, and how we can relate and communicate to get to the desired outcome.
We’re always working with all the capacities in mind
I hear Colette Ryan shouting to us, “Meaning Making!” and it also makes me think of the podcast with Dr. Ira Glovinsky about how affect depends on interoception where we discussed how emotions are made. Sometimes when we are overwhelmed and things aren’t working out as planned, we do get aggressive and parents often unknowingly place unrealistic demands on their children. Mike says we have to figure out if there is a way to meet that need that the child has to be aggressive that is not dangerous.
Mike says that many adults on the spectrum have described self-injurious behaviour as a way to relieve the overwhelming sensory input. It’s a way to focus everything that’s coming in and bring it to one point. It’s a type of relief: adding more intense stimulation overrides the overwhelming stimulation. Mike continues that this action is not in the higher capacities. You’re in more of a primal, sensory state, he says. There are things that happen before the signals get to our brain’s cortex, so these behaviours are not always a willful thing.
You can only Floortime before by taking proactive steps and ‘debrief’ after to help the child make meaning after the fact, but during you can only co-regulate through the bumpy part. When we’re in that emotional state, Mike says, our higher capacities are shaking the most and are the most unreliable. So when parents say, “Well, they were able to do it before so why can’t they do it now?“, maybe they’re hungry or now there’s a sound getting in the way. Everything is so dynamic and complex, Mike explains.
We talk about the Functional Emotional Developmental Capacities (FEDCs) as if we can separate them, but they’re not. We work on reciprocity in the 3rd capacity while we are co-regulating, while respecting the individual’s sensory processing differences and the Relationship to sustain engagement. For Mike, it’s like thinking about trying to separate the oregano out of the spaghetti sauce! You just can’t do it. It’s one of the tricky things with Floortime. We started out talking about aggression, but then we end up talking about all these related things since we talk about the foundation for relating, communicating, understanding our body and feelings–including our sensory part of emotions and the symbolic idea part of emotions.
Trauma and the Body
Mike mentioned he has been reading about trauma: specifically Bessel van der Kolk’s ‘trauma bible’ The Body Keeps the Score and Peter Levine. With trauma, talking about the event can be triggering, Mike explains. The body needs to process stuff. If the body can get through it, then the cognitive stuff isn’t the big thing anymore. The body not being able to complete the process of fight or flight means getting stuck, which compounds and builds a pattern in our brain and body that when this happens, things get worse.
So being able to get to the body and separate when you’re scared or angry and what it feels like in your body (the interoception piece) allows you to begin to recognize the body feelings and intervene. Before aggression happens, we can we control our breathing or do something with our bodies like deep pressure–whatever the body needs to get through that stuff. We process this when we’re calm and engaged and can get to our higher FEDCs. That’s the way around aggression, Mike says–not in the moment.
Finding the Clue
Mike says we want to convey the message that, “I’m not leaving you. I’m still here, but I’m behind the door because we need to stay safe.” We want to let someone know that even when things are bad, you’re not alone, even if you need me to not do anything. I’m around when you’re ready. So number one, let’s get some outside eyes in if you’re struggling with this to help you figure out what’s going on that is making the individual be in a ‘fight’ response. Next, let’s take proactive steps to prevent what we can and figure this out by looking at what happened right before the aggression started as one clue.
Was there a trigger? What can we put in place to help the child feel safe? Next, what can we do to co-regulate during the aggression, as we discussed. And then after the fact, work on re-establishing the Relationship, reassuring them that we’re there for them through our actions. Maybe we give a sigh and say, “That was hard.”
Mike adds that anytime an individual goes into fight or flight, or even if you just lose engagement, it means that whatever just happened was too much. It’s beyond their ability in the moment to deal with. What happened right where that shift occurred, Mike asks. Manipulation is a very sophisticated social idea, so when parents say that the child is being manipulative, Mike sees that as a praxis problem. They only have one idea for what to do when they feel this way, which might set off a parent or teacher. That puts an end to where it shifts to what just happened. Before and after, work on praxis. This helps make things predictable. When we can anticipate what comes next, we can stay a bit more regulated.
Your Guide to Aggression
Dr. Mona Delahooke has some good discussions on neuroception, Mike says, including that there’s no such thing as ‘Oppositional Defiant Disorder’–it’s just faulty neuroception. Our body says something is a threat, so we don’t feel safe and we can’t problem-solve through that. Dr. Stephen Porges has shown that our bodies filter out frequencies in the speech range when we’re in fight or flight, so if we try to talk to someone in crisis, some of that will be lost. When we get stressed, one of the first things we drop is speech.
Saying, “Use your words!” doesn’t work. We have to deal with safety first, in the moment. Then, the Floortime stuff is before and after. Afterwards we can ask what it was like or play it out with figures to reenact a scenario, Mike suggests. Mike loves therapeutic role-playing games where you can take something that’s similar to a real-life experience and play that in a game to experiment with different scenarios.
Mike’s final words are to be compassionate, understand that there’s a blackbox and something happening that you can’t ever really know, and examine the Individual differences of the individual and of yourself. Are you a good fit with each other? If not, what can you adjust?
This week’s PRACTICE TIP:
This week let’s take note of cues our children give us right before they get aggressive so that we can be proactive going forward and also ‘debrief’ afterwards through Floortime play or conversation.
For example: Does your child start to move and pace a lot more? Is your child getting frustrated trying to get something to work that isn’t working? Is your child trying to get your attention? Once you note the cues and what happened before aggression, take steps to prevent this in the future. After the fact, play out the scenario with figures or let the child know you empathize with what they went through, through caring hugs, a soothing voice, or a discussion about it if they are at that stage.
Thank you to Mike Fields for delving into all of the factors surrounding aggression in our kids. I hope that you learned something valuable and will share it on Facebook or Twitter and feel free to share relevant experiences, questions, or comments in the Comments section below.
Until next time, here’s to choosing play and experiencing joy everyday!
A few points. One thing that was said at the end about revisiting the challenging event or “what happened before” through symbolic re-created play scenarios (once the child is calm) does not need to be only through children who have attained the capacity for symbolic ideation/language. Rather, it can as I have done for the past two decades through deepening reciprocal attachment and attunement (i.e. regulation/co-regulation) suddenly “Playing dumb” and have the scenarios of limbic-autonomic driven “All or Nothing” meltdowns happen quite a few times again. Proactively creating or instigating anew the disrepair and then co-repairing. This creates greater resiliency. In other words, we are establishing the connection, then breaking the connection (e.g. the line of toys breaks or the ball, etc., get stuck). Then, slowly by affectively giving voice/mirroring the child’s upset, as well as at the same time inflexion/intonation of voice and somatic affective attunement to down-regulate) co-repairing it WITH our child. By doing the latter we are conveying to and with our child and more importantly guiding families to do so (i.e. on a bodily based limbic-autonomic level and through vocalization, pause, inflexion/intonation of voice) that s/he can come back (as well as the parents). What then occurs is that slowly implicitly-procedurally becomes part of their co-affective engagement, relational dynamic with others. Unfortunately, this is not done as much as it should be for fear of dysregulation.
The other thing, it is necessary to understand that individual affect-sensory processing differences (under or or mixed responsivities across all domains) are (at least as I view them and listening to Steven Porges some years ago just further confirmed it ) that so much taken to be causal, i.e., individual sensory processing differences, are much more significantly manifested in the first place and conversely reduced by helping change that child’s state regulation (i.e. autonomic state). In other words, too much focus by clinicians is placed on the child’s sensory processing differences, however, they lay on top of, if not driven by, disorders in state regulation. For example, from the child’s perspective (or any age), “Do I feel safe to engage with you and my surroundings or is my sympathetic-adrenal system appropriately/adaptively mobilized for defensive fight/flight behaviors or worse, parasympathetic withdrawal/shutdown and/or dissociation?”
The third point is too much emphasis is given over to the FEDC levels (functional emotional developmental capacities) as though they are so categorically distinct, compartmentalized and achieved or not achieved or fallen back to earlier level, etc. What this tends to do (and it is naturally a problem in any field when we become too mechanical, left-brain hyper focused on the “outlined levels” as though they are clearly distinct without admixture) we miss the many nuances and complexities of our engagement and associated reflective capacities with the child. When we begin to over focus on the delineation/categorical distinctions of the child, we miss so much of the in between.
Hi Neil, I’ll alert Mike to your comment so he can reply, too.
Thank you for your insights. I agree that this process of co-regulation is so important and avoiding dysregulation and walking on eggshells is something parents do for fear of the dysregulation. I don’t know that I would intentionally instigate it as there are enough instance of natural dysregulation in the day, anyway, but I hear your point. Just an FYI: we now use the term, “playing confused” over “playing dumb” (see this document: https://www.autistichoya.com/p/ableist-words-and-terms-to-avoid.html)
Your second point supports the main point Mike made throughout the podcast: safety is first. If the child doesn’t feel safe, forget about regulation and the rest. Focus is that “perceived” sense of safety, which you are calling state regulation, yes. We agree.
Your third point is also what Mike stressed, so thank you for highlighting this important point that Mike made: You can’t take the oregano out of the spaghetti sauce. There is no one FEDC in isolation. Agree, again.
Stay tuned for an upcoming podcast about Kinder Growth where we discuss your last point–that we don’t have an “instruction book” for Floortime and need to take an organic approach where we are in the moment, better explained in the upcoming podcast.
Thank you for your comments and I hope that others will take in these important points that you emphasized.
I think you are expressing a common concern with regards to pushing buttons further and would appear prima facie to be a great deal counter intuitive not just for our families but many therapists working with them resulting in why in the world would I even begin to do that?. “If my child has so many disruptions, dysregulation, during the day, is it really wise to instigate them, to add further fuel to an already difficult situation?! Thank you, but there is enough to work with my child as it is, s/he does not need more!”
I think what needs to be much better understood is that there is a fundamental difference between intentional strategic incidental dysregulation by the family and therapist with their child in playfully disrupting the back and forth affect reciprocal engagement once established in contrast to the innumerable minor, moderate or All or meltdowns throughout the day which we try with our child to calm and down regulate through vocalizations of calm and empathizing back to his/her internal (interoceptive) feelings of safety back through co-regulated engagement.
What many therapists and families in my experience are not quite getting taught or sufficiently enough is an understanding about a much greater capacity that all children have regardless of where s/he is to instinctively read affect cues beneath the surface (i.e., the other’s intention neuroceptively and interoceptively) and his/her resiliency than we have been typically taught to attribute.
Yes, naturally resiliency has to be built up with our child over time…but what I am suggesting would also be an essential and integral part of that process, if we put aside our fears of upsetting the wheel cart once it (engagement) is rolling. Let’s take Tronick’s famous Still-Face paradigm: Mother and child are told to warmly, playfully and enthusiastically engage as normal, then mother is told to suddenly stop; baby then attempts to re-engage mom but to no avail; baby’s autonomic nervous system goes from heightened anxiety to extreme upset then we see a withdrawal/shutdown, basically gives up. Mom is then told to re-engage her baby. It takes a moment or two BUT then, then their autonomic nervous systems are in synch once again, that is, recovered back to where they left off, warm, normal, high happy engagement. Well, what is often missed here (or insufficiently understood) is that it is in that Co-Repair that mom and baby together effected a greater resiliency and the associated neuronal connections are considerably strengthened prior to that disruption.
My point here is that it is precisely through once establishing connections, simple to complex reciprocal engagement, then for no particular reason breaking those connections that there that co-repair can take place and positively strengthens the whole child/primary caregiver dynamic.
For example, Child is playing with trains on track, suddenly trains fall off or track breaks. Or once we have a little nice back and forth play with the ball, the ball gets stuck under the couch, etc. Now, this happenstance you might naturally assert is going to happen of course anyway, “So why push it to make it happen when we can co-repair (two-way reciprocal emotional problem solving) when they do happen? Those moments, you might say, of back and forth reciprocal engagement are difficult enough and we are trying to deepen and expand the functional emotional developmental capacities?!”
The answer (somewhat similar to the Still-Face paradigm) is that then we can control it (mind you I am not using “control” in a traditional behavioral sense). In other words, we can co-repair affective gestural and verbal reciprocity in a more nuanced and meaningful way- and most interesting of all the child eventually neuroceptively and interoceptively catches on to us, perhaps not in words but in the integrity and resiliency of his facial-bodily affective exchanges, where the resiliency and qualitative nature of those exchanges are much more broadened than they were before!
As we co-repair these moments with our child, his/her resiliency and neuronal connections are actually strengthening, along with the entire scope going forward of his/her developmental capacities (i.e., executive functioning). What I am suggesting is intentionally viewing and enacting these “problematic affective breaks” much more than currently is the thinking throughout all our interactions (depending upon where our child is at any given moment) as neural exercises. At higher developmental capacities (level 5 and 6) they get translated into various symbolic-play scenarios, for example, conflicting emotions and conflict resolution through the characters in the play, etc.
I hear you saying that as each ‘rupture’ gets ‘repaired’ through our co-regulation with our child, it builds the child’s resiliency to withstand future ruptures. If done in the context of safety and relationship, yes, I agree.