Change the Lens: Change the Life The Nurtured Heart Approach and more… Annie Lange, LMSW, ACSW www.AnnieLange.com 517 719 1523

Why are we here? Why are we here today???

Objectives Describe relationships between trauma, brain function, attachment, empathy and relational connection between adult and children. Discuss the neurobiology of the stress response. Have a working knowledge of the thought cycle and its effects on feelings and behavior. Discuss concrete strategies to support attachment, self/child regulation and healthy self-esteem, including the Nurtured Heart Approach Model.

Change the lives of Children and Adults Change our Lens Change the lives of Children and Adults

Every child is born with beautiful potential

Potential Blocking Accident Natural Disaster Violence Domestic Community School Neglect Illness Child Abuse Sexual Physical Emotional Adversity 6

Caregivers can make a difference… 7

Attachment Care Giving Video

Effects of Trauma & Stress Adaptation vs Pathology (Survival) Goal: Build positive developmental pathways and competencies that support current and future resilience. Blaustein, Kinniburgh 2010 10

Core Concepts of Childhood Development Nurturing & dependable relationships = healthy childhood development Humans hardwired to connect Attachment changes the brain Child development shaped by nature and nurture, biology and experience Blaustein, Kinniburgh 2010 11

Core Concepts of Childhood Development Self regulation is essential for child development and life-long health Balance of risk factors and protective factors determines level of healthy development Orlans, Levy 2006 12

Care giver’s developmental health impacts child’s developmental health 13

The Developing Brain 14

The Developing Brain The brain is a social organ and develops in the context of relationship Genes provide framework, life experiences directs final construction “Use it or lose it” The first three years of life is most critical

Triune Brain

The Brain Rational Brain Mammalian Brain Reptilian Brain

Adverse Childhood Experience Study Adults who experienced at least four traumatic events in childhood have increased risk of: Morbid Obesity Smoking Depression Illness Unwanted Teen Pregnancy Domestic Violence Felitt and Anda (2003) 18

Trauma and Memory Explicit Memory: non emergency memory, logical, has words Implicit Memory: expressed in body as well as emotions, created by neural firing, no time stamp, experienced as if in the “NOW” moment

ADHD Disabilities vs. Hyper-Arousal Inability to be reflective – think before acting Selectivity: unable to focus and screen out important from the unimportant Continuity of Attention: inability to sustain attention and complete assignments Self-awareness and self-regulation: not able to be responsive to positive and negative reinforcement 20

Neuroplasticity The ability to change patterns of energy and information in response to new experience The hope of healing lies in the ability both within the mind and between minds to modify wired in painful and frightening experiences Psychotherapy/care giving can be a mutual engagement that can change both structure and function of the brain= Neural Integration Sharing this info with client’s brings them hope, parents of children with trauma, this brings them hope! Badenoch, 2008 21

Human Danger Response Step 1: Danger Beliefs “lens of danger” Step 2: Body and Behavior Responses “Fight – Flight – Freeze” Step 3: Compromised Healthy Development Regulation Self * Social * Cognitive Blaustein & Kinniburgh 2010 22

Common Childhood Trauma Triggers Perceived lack of power or control Unexpected change Feeling threatened or attacked Feeling vulnerable or frightened Feeling shame Feeling deprivation or need Intimacy and positive attention Blaustein, Kinniburgh 2010

Attachment Healing Caregiver Management of Affect Attunement Consistent response Routine & Rituals Blaustein & Kinniburgh 2010 24

Challenging Child Behavior Triggering Adult Child’s triggered response Anger / Opposition/ Blame Demand for affection Patterns of approach and rejection Extreme response to stressors Reduced sense of efficacy Guilt/ Shame Shutting down or contradicting Over-reactive Being overly permissive Blaustein & Kinniburgh 2010 25

Affect Management Self-monitoring skills Affect Management Skills Body ~ Thought ~ Emotion ~ Behavior Affect Management Skills Building a Support System Blaustein & Kinniburgh 2010 26

Affect Management Taking Care of Self Deep Breathing Muscle Relaxation Distraction / Movement (Tai Chi) Self Soothing / Self Care Thought Cycle Mindfulness/Thought Surfing Meditation QTIP 27

Thought Cycle 28

Thought Travel

Thought-based Principles First Step: Awareness / Mindfulness / Attention State of Mind not dependent on what is going on 90% of time it is the thought not the event that determines the experience Response Ability Passenger or Driver of the Thought-Train 30

Rule Book (agreements) What is Stress? Circumstances + Thought Story Rule Book (agreements) State of Mind 31

Understanding Triggers Trigger: A reminder of a past event that can lead to same set of emotions and behaviors Blaustein & Kinniburgh 2010 32

Blaustein & Kinniburgh 2010 Attachment & Triggers Avoid or withdraw from Caregiver Overly clingy and unable to take in support Freeze Appear “manipulative” or try to control Conflict approach / avoidant behavior Blaustein & Kinniburgh 2010 33

Muddy Mind

Wheel of Awareness Siegel, Bryson 2011

Viewed through our Lens Mindfulness Thoughts Feelings Behavior Something Happens Viewed through our Lens 37

Mindfulness Awareness on Purpose Of Present Experience With Acceptance 38

With… Curiosity Kindness Compassion

Thought Surfing

Thought Surfing Identify Thought Sit back and watch, don’t act, observe Note the sensations Be aware of triggers Remember it is temporary, transient Use a helpful mantra “This too shall pass” Keep practicing Steven Handel

Meditation Belleruth Naparstek 42

Change the Dance, Change the Child: Attunement “I see you”, “I hear you” Attunement is a moment to moment, day to day process Attunement fosters co-regulation 43

Consistent Caregiver Response Active Listening Self Regulation Focus on Positive Consistent behavior management Blaustein & Kinniburgh 2010 44

Care giver Strategies Star Q Tip (Bailey, 2001)

The Nurtured Heart Approach Utilizes the challenges and intensity to create success Creates first-hand success in the “NOW” moment Helps create a new portfolio for the Child 46

The Nurtured Heart Approach The approach has three basic aspects: Super-energizing experiences of success. Refusing to energize or accidentally reward negativity. Providing a perfect level of limit-setting and consequences. 47

parent*teachers*workers The adult in a child’s world is the ultimate prize ! parent*teachers*workers When do we give the $100 bills?

The Three Legged Approach #1 I will purposefully create success for the child #2 I refuse to be drawn into accidentally rewarding and energizing the negative #3 I will provide a true consequence when the rule is broken

More than catching kids being good!!! “Shamu” “Toll Booth Man”

Techniques for Energizing Successes in Children Active Recognition – a “snapshot”; noticing and describing what’s going on in this moment. Experiential Recognition – ‘The Big Picture’; Connecting the positive behavior that you notice to values. Proactive Recognition – Noticing when rules are not being broken. Creative Recognition – ‘Creating Success’ where it isn’t ordinarily seen, or doesn’t ordinarily exist. Shamu 51

Blaustein & Kinniburgh 2010 Time Outs Provides Child space to calm from distressing moment “RESET” Used for impulsive or unsafe behavior Blaustein & Kinniburgh 2010 52

Blaustein & Kinniburgh 2010 Trauma & Limit Setting Reduce need for limits through limited choice Compromise Choose your moments (flipped brain) Be aware of Triggers Blaustein & Kinniburgh 2010 53

Blaustein & Kinniburgh 2010 Limits as Triggers Fear of abandonment & rejection Always name rationale for limit linking it to behavior Moving on (mulligan) Making adaptations to limits for specific triggers Blaustein & Kinniburgh 2010 54

Blaustein & Kinniburgh 2010 Considerations Start small and build Start with reinforcement rather than limit setting Don’t start with the most difficult behaviors Blaustein & Kinniburgh 2010 55

Build Routine and Rituals 56

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” - Maya Angelou

To your Greatness!! Annie Lange BSN, LMSW, ACSW Clinical Social Worker Nurtured Heart Approach Advanced Trainer Annie@NurturedHeartPath.com 517 719 1523 http://www.nurturedheartpath.com

Change the Lens, Change the Life Bibliography Badenoch, Bonnie (2008) Being a Brain-Wise Therapist; A Practical Guide to Interpersonal Neurobiology. New York, W.W. Norton & Company, Inc. Blaustein, M. and Kinniburgh, K. (2010) Treating Traumatic Stress in Children and Adolsecents, How to Foster Resilience Through Attachment Self-Regulation and Compentency. New York, NY: The Guildford Press. Forbes, H. and Post, B. (2006) Beyond Consequences, Logic and Control, Boulder, CO: Beyond Consequences Institute, LCC. Glasser, H., Easley, Jennifer (2008) Transforming the Difficult Child: The Nurtured Heart Approach, Nashville, TN: Vaughan Printing. Glasser, H., and Block, M. (2007) All Children Flourishing, Igniting the Greatness of Our Children. Nashville, TN: Vaughan Printing.

Change the Lens, Change the Life Bibliography Hendrix, H., and Hunt, H., (1997) Giving the Love that Heals: A Guide for Parents. New York, NY: Pocket Books. Hughes, Daniel A. (2009) Attachment Focused Parenting. New York, NY: W.W. Norton & Co. Inc. Hughes, Daniel A. (2006) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children. New York, NY: Jason Aronson Orlans, M., and Levi, T. (2006) Healing Parents: Healing Wounded Children Learn to Trust and Love. Washington, DC: Child Welfare League of America, Inc. Pransky, J. (2008) Somebody Should Have Told Us (Simple Truths for Living Well). New York, NY: Strategic Book Publishing. Purvis,Karyn B., Cross, David R. and Sunshine, Wendy Lyons (2007) The Connected Child. New York, NY: McGraw Hill. Siegel, Daniel J. (2003) Parenting from the Inside Out. New York, NY: Penguin Group. Siegel, Ronald, (2010) The Mindfulness Solution. New York, NY: The Guilford Press