Self Regulation in FASD and me

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According to Merriam-Webster:

Definition of self-regulation

the act or condition or an instance of regulating oneself or itself: such as; Self Regulation: the bringing of oneself or itself into a state of order, method, or uniformity emotional self-regulation.

We know individuals with Fetal Alcohol Spectrum Disorder often struggle with self-regulation, which can lead to many problems throughout life, but how many of us really understand what it is? Difficulties with self-regulation are part of executive functioning, which are higher level cognitive functions, such as inhibition, problem solving, attention, planning, etc.

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A 2018 published study by Kamaldeep Gill & Sandra Thompson-Hodgetts: Self-regulation in fetal alcohol spectrum disorder: A concept analysis revealed

in relation to FASD, attentiveness, thoughtful & deliberate actions, calm & collected behaviours, inhibition, and emotional regulation are the defining attributes of self-regulation; resulting in an operational definition that is unique to this population.

This means a person with FASD may have trouble calming down or is often irritable or on the opposite end quick to anger and explode. Another study: Emotional Understanding (EU) in School-Aged Children With Fetal Alcohol Spectrum Disorders: A Promising Target for Intervention,  led by Christie Petrenko, assistant professor at the University of Rochester’s Mt. Hope Family Center revealed that children with fetal alcohol spectrum disorders (FASD) show a striking developmental delay in their understanding of emotions. Even in those children with an average IQ, researchers found that their emotional understanding was lagging by two to five years behind their typically developing peers.

Many children with FASD have considerable difficulty with managing and regulating their emotions and behavior, so it makes sense that they would have delays in emotional understanding.

People with weaker EU may have poor awareness of how their emotions and behavior affect others, which can cause a lot of social problems,” Petrenko explains. “Also, kids with FASD often experience more negative emotions than other kids their age. They may also feel bad about themselves, especially if they don’t get supportive responses from adults in how to cope with strong emotions.”

The researchers conclude that treatments for FASD should therefore focus on improving emotional understanding.

“When paired with skill building in emotion regulation and support from adults, such interventions could improve the adaptive functioning of kids with FASD,” says Petrenko.

But this happens to people without FASD. And this happens to caregivers. So imagine if your own self regulation isn’t in check? A key component to self regulation is how a regulated adult regulates a child. Or any two people – it doesn’t have to be a parent to child – it could be a teenager to teenager or parent to adult child or friend to friend. We need to access the reasoning part of our brain, not trigger our limbic system in response to our child’s own fight, flight, freeze or fawn response.

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Until I adopted the maiden I had no idea what self regulation was. Let alone realize I was not skilled in it myself. So were many of the continued outbursts a result of FASD or me? I think many of us who are parenting or supporting a person with FASD feel guilty for not knowing the things we didn’t know – and wondering if we did things differently would things have turned out differently. I know there were times when the maiden was younger that I could have done better – but until I realized what needed to change in me I couldn’t. I have said it many times, adopting the maiden has made me a better person.

So where do you begin? In its simplest form, for me, it is remaining calm and being present with our children through their big emotions. And then helping them process after the storm has passed. It is not saying, calm down, stop crying, or getting into a power struggle. And it is by modelling calm and acceptance a child learns calm and acceptance.

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In the article Helping Children Learn to Regulate Their Emotions by Dr. Carolyn Webster-Stratton, she indicates that self regulation is a “developmental achievement” which is not present at birth. There are different factors that determine how quickly a child learns emotional regulation, such as:

  • the child’s neurological inhibitory system which controls emotions;
  • the child’s temperament and vulnerability due to learning difficulties, language delays attentional deficits and temperament; and
  • parental socialization and environmental support. This is everything from how families talk about, express and regulate feelings to chronic stress or a lack of predictability and stability.

So what can a parent or caregiver do? Dr. Webster-Stratton suggests quite a few strategies. I do not agree with her “time out” for inappropriate outbursts but she does suggest others that, depending on child and developmental age, can be used:

  • provide as much consistency and stability as possible;
  • accept child’s emotions and emotional responses;
  • talk about your own feelings;
  • encourage your child to talk about their feelings;
  • model emotional regulation;
  • teach children positive self talk about the event (such as “Everyone has parents who get mad a them sometimes.” “I can handle this.” “I can calm down.” “Everyone makes mistakes.” “She’s just in a bad mood today.”;
  • identify situations which result in emotional explosions and use them as springboards to teach problem-solving; and
  • help children be aware of the stages in the build up of tension.

I know that I was able to support the maiden most of the time in many of these …. but the model emotional regulation I failed at more than I was successful. It is only as I raised the maiden and learned about her abilities or inabilities, that I then learned where some of my (in)abilities needed work.

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I did not come from a home that modeled self regulation. In fact my home was filled with chaos, physical punishment and verbal/emotional abuse. I won’t get into details, but I can safely say that I don’t think my parents were modeled self regulation, so they did not have the skills. I also know trauma has alot to do with development. We were brought to another country when very young – I was taken away from a larger support system, then lived in a home with a father with addiction issues. I’ve spent many years of my adult life in therapy trying to understand and change my negative patterns, but the one I still struggle with is self regulation. Most of the time I can control it …. but I am learning about my triggers, my responses and practicing the pause. I very rarely default to fight or flight, but I still freeze.

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I’ve been to Cognitive Behaviour Therapy Groups. I try to be mindful and remember to breathe. But I have many years of unhealthy coping habits to unlearn. The maiden and I went to a 12 week adapted Dialectical Behaviour Therapy group last year. It was a good introduction but as I indicated to the facilitators, it really should have been much longer. The skills were reviewed very quickly and even the information still needed to be put into simpler terms – but it was a program in development. It would be great if it was run again with more in depth sessions and time.

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But until then, we still have the ongoing issues in our house. Part of the problem is living in the house with the Crone. I have tried to talk to her about how can we change how we speak to or react to one another. But I have been “fighting” this battle all my life with her. She refuses to acknowledge she has any part in it because she can’t see it. She feels she is too old to change (but I heard that 20 years ago whenever anyone tried to suggest change). She says she is who she is. That I am too sensitive. The maiden too lazy.

It is great practice to live in a household where one has to call on these skills – but it is also very tiring. However I now see and hear the crone in the maiden. She is quick to respond, angry, sarcastic; reacts or flees rather than manage her emotions.  She mirrors what she sees. And obviously my skills in self reg aren’t strong or she’d be mirroring me.

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So I have to try harder. I don’t want her to go through life like I did. I want her to use different coping skills. It isn’t going to be easy. I’ve been trying all my life. But now I’m getting it from both ….. one doesn’t want to try to change and the other needs a more positive role model.

So while the pandemic is on and we are all in lockdown, there have been so many on-line courses opened up that once were expensive or that I didn’t even know about. One is from The Mehrit Centre and Dr. Stuart Shanker. It’s a 30 day Self Reg Challenge. I’m two days in.

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So far I’ve been reminded about the different parts of the brain and how when the old part of the brain (limbic or reptilian) is triggered it shuts down the newer part – the Prefrontal (PFC) or Cerebral Cortex – the reasoning brain. How we need to be aware of what part of the brain is running the show.

We need to learn to soothe the PFC brain and turn off our limbic alarm to prevent it from shutting down the prefrontal cortex, preventing the fight, flight, freeze and fawn response in those times when they are truly not needed.

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I’m hoping that by continuing to learn about my brain and how it works that I will be better prepared to respond when I am triggered. I need to teach myself. To be the person I needed when I was younger. In turn, helping the maiden, before she spends a lifetime responding with her ancient brain. Stay tuned.

Until then, think about what part of your brain is running the show?

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