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Emotional Regulation Dr Kayleigh Brown, Clinical Psychologist Poli Begum, Chartered Clinical Psychologist.

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1 Emotional Regulation Dr Kayleigh Brown, Clinical Psychologist Poli Begum, Chartered Clinical Psychologist

2 Aims What are emotions and what are they for?
How does emotional regulation develop? What things get in the way of emotional regulation? How can I help my child recognise and regulate? Aim: to understand some of the reasons why your child might find it difficult to regulate or manage their emotions By the end, hopefully you’ll have an understanding of who and what might need to change and strategies to starting to put those changes into place.

3 Part 1: What are Emotions?

4 SAD HAPPY ANGRY DISGUSTED PANICKED EMOTIONS FRIGHTENED CONNECTED PLAYFUL CARING ASSERTIVE

5 The purpose of emotions
Helping animals to survive for millions of years Tell us what gives us pleasure and pain Help work out where we are, where we need to be and how to get there If we ignore our emotions, we can feel depressed or anxious Have been present in mammals for between 30 and 300 million years.

6 As human beings, we’ve got ourselves caught in a belief that there are ‘good’ and ‘bad’ emotions. Of course, some feel comfortable and some feel uncomfortable but this is something we’ve learned rather than an instinctive reaction.

7 In reality however there are no objectively ‘good’ or ‘bad’ emotions, they are all signals that are trying to give us important messages. This is important for teaching emotional regulation skills to children because they need to feel that all of their emotions are important and valid to be able to express them appropriately. The problems often come when they’re ashamed of their emotions and therefore try to keep them down, leading to emotional build up and, eventually, meltdown. So each time your child feels an emotion, encourage them to ask “what is this feeling trying to tell me?” We have some example here… stressed tells us to slow down, sad tells us that we’ve lost something important and need to care for ourselves, anxiety tells us that we don’t feel safe and need help to feel calm and grounded…

8 Excitement Similarly, excitement gives us energy and motivation to go and find what we want and what we need. tells us what is important to us helps us explore and be curious

9 Anger We feel angry when we don’t get what we want and what we need.
Feeling anger is different from aggression or violence, it simply gives us the energy to put in place boundaries, and tell us what we will and won’t put up with in order to feel safe and ok.

10 The only time we do not feel, is when we are dead (Jon Frederickson, 2013)
The reality is, we all have emotions all of the time, and it’s important to listen to them. The only time we don’t have emotions is when we are dead.

11 Part 2: Developing Emotional Regulation
So message 1 is that we all have emotions and they’re important but of course that is just one part of the picture. In society, as human beings we also need some level of control over our emotions to ensure they are expressed in an acceptable and safe way, suitable for the environment which we are in. This requires us to develop skills in emotional regulation.

12 What do we mean by emotional regulation?
A lifelong developmental process Underlies attention and social engagement Essential for optimal social, emotional and relational development Well regulated = most available for learning Poor regulation may lead to tantrums, rigidity, anxiety and disconnection So what is emotional regulation? Emotion regulation means that we can tolerate emotions that might feel uncomfortable such as fear, anger or sadness, without being flooded by the feeling or having to avoid it completely, because we have developed confidence in our ability to cope with that emotion. We can listen to the important messages that emotion provides, without getting overwhelmed. Lifelong – ER is a life long process that happens over time. Infants can’t regulate their emotions at all, it is something they learn with the support of their caregivers over time. it is only as individuals move into adulthood and possibly our mid to late 20s that are brains are more fully formed and we can regulate independently. Attention – ER also underlies impulse control and our ability to focus and concentrate. If we are distracted by our emotions, this can have consequences academically and socially. Social/emotional – If we can’t regulate emotional reactions in our interactions, this can negatively impact on social, emotional and relational skills. Those with better ability to ER are more able to participate in social settings; more sought out more by other children; and families experience less stress Optimum regulation: There is a continuum of states: Tigger, winnie, eeyore. You need to be at the optimal winnie the pooh stage to be able to stay alert whilst maintaining focus. For example, to deliver this session you need to be appropriately regulated (not too relaxed that you’re falling asleep but not too aroused that you can’t focus). Poor regulation: Those who struggle with emotional regulation may be more likely to have tantrums or emotional meltdowns, or may be excessively rigid; they may also avoid or become anxious about emotional expression. They may be more likely to feel disconnected from others So clearly, ER is very important.

13 Window of tolerance Learning emotional regulation involves developing a window of tolerance – a window within which emotions can be tolerated and we can process and act on information appropriately. It is the state where we are most flexible and able to learn and grow. We develop this window by learning to regulate our emotions as children, learning with our parents or caregivers what emotions are and what to do with them. Everyone has a different sized window of tolerance based on past experiences. Some are narrower, some are wider. The wider the window of tolerance, the easier it is to feel emotions without them feeling too overwhelming. If the window is small, emotions are more likely to feel overwhelming. They are more likely to lead to fight, flight or freeze responses, making it harder to stay calm and employ strategies to keep our emotions regulated. Our window might be small for a number of reasons, for example due to trauma or other difficulties such as ASD. With the right support however, we can learn to slowly widen our window of tolerance.

14 The typical development of emotional regulation
We all use both physical and verbal expressions of emotions Most people use both together As we get older, we get better at using verbal expression to help others understand how we are feeling So how does emotional regulation develop? The rational and emotional parts of our brain slowly learn to talk with each other and regulate our emotional expression. We go from a place of needing regulation by our parents, to co-regulation and finally the ability to self-regulate as we internalise this process for ourselves.

15 The typical development of emotional regulation
In the first stage of development, we rely on others to regulate our emotions for us In the first year of life, we have very little self control and little understanding of our emotions. We have random messages firing away in our brain and sensations in our body but no understanding about what this means. When an infant comes into the world, they are absolutely helpless and dependant on their caregiver for their survival. Not just for their physical survival (food, safety etc) but also for their emotional wellbeing. So when they’re in emotional distress, the caregiver identifies their needs and attends to them, enabling the child to feel comfortable and safe again. This process creates networks and pathways in the brain, to help the child learn about what to do to soothe themselves when they feel distressed. They learn about their emotions and what they mean, through the parent soothing them and teaching them how to cope.

16 The typical development of emotional regulation
As we reach toddlerhood, we enter the stage of co-regulation. As humans, we are biologically hardwired to experience emotions, however how we learn to express and regulate our emotions is very much shaped or learned by experience. So when a toddler has an emotion, the way the caregiver responds to it will teach them how to cope or regulate that emotion in the future. If they feel sad for example, the biological underpinning and physiological sensations might lead them to cry but it is the parents’ job to identify what this means and how to respond appropriately; therefore engaging in a process of co-regulation. In an ideal world this stage involves both the parent comforting the child physically and emotionally but also using language to model and teach their own emotional intelligence skills. Having that comfort and hearing the words at the same time helps the child to understand their subjective experience. Having the experience of being held and understood helps them naturally begin to understand their own internal world and know what to do with it. At this stage, it’s really important to be accepting of the child’s emotions rather than challenge them. So if the child feels upset and they’re told “there’s nothing to cry about” or “this really isn’t important” or “cheer up, it’s not so bad”, they don’t learn this important stage of developing emotional regulation skills. This strategy teaches the child to distract themselves from their emotions, as if they’re not important. Instead, they learn that their feelings are wrong or unimportant and so they avoid their emotions, leading to a build up of distress and more likelihood of meltdowns or greater distress in the long term.

17 The typical development of emotional regulation
As they get older still, children develop more of an understanding or their internal experiences. Not only will they feel the emotion but the parents’ modelling of soothing and labelling the experience for the child will become more internalised so they can communicate their emotions independently. There may also be fewer triggers as their increased independence and mobility means that they are more in control and able to make good choices for themselves.

18 The typical development of emotional regulation
During teenage years, things become more complicated and triggers increase as a difference develops between what they think they’re capable of and what they’re actually capable of. “You’re getting in the way of what I want” might become a common phrase or thought, so anger and tantrums increase. Thinking skills are improving but this is counteracted by the number of triggers. This process continues to improve into adulthood however until they are able and willing to employ the emotional regulation skills learned throughout their childhood. However, as they reach adulthood, not only do their emotional regulation skills become more solidified, their independence increases too. They can choose make good choices about the things that are right for them, leading to less distress and more ability to life a life in a way that is important to them and what they want and need.

19 Why do we lose control of our emotions by Kids Want to Know - YouTube
So learning how to understand and regulate our emotions is part of a learning process that takes time, as our brains develop. It involves different parts of our brain, that slowly learn to communicate with each other through modelling, practice and repetition. The hand model is a way of understanding how our brains work and develop. Take your thumb and put it over the middle of your hand and put your fingers over the top – this is a representation of the brain. So here we have the spinal cord, going up into the brainstem and limbic system, which work together to regulate arousal and your emotions, as well as the fight, flight, freeze response. You then have a higher part of the brain, the cortex, which sits over the top and allows us to perceive the outside world, think and reason. This front part of the hand/brain is the bit that regulates all the bits going on downstairs in the emotional part. In an ideal world, these two parts sit closely together and communicate well, so that we can have emotional experiences but also regulate them so they do not feel overwhelming. This process of communication takes time however and the two parts of the brain aren’t really fully connected and communicating consistently until people reach their late 20s. So what happens when these two parts aren’t communicating so well? Sometimes this downstairs part of the brain gets fired up and start rumbling – it responds in fight, flight, freeze mode in situations which might be threatening. Maybe we’re tired, stressed, we heard a dog bark loudly, someone shouted, or someone has simply pushed our buttons all day. All kinds of things can happen, which means that our emotional brain starts rumbling and we can ‘flip our lids’. This process creates a gap in communication between the emotional and rational parts of our brain and stops us acting rationally or flexibly. We lose communication with the upstairs part, which would normally stop us acting impulsively and help us to calm down. As we get older, these two parts naturally communicate much better with each other but as children, these two parts don’t always communicate well as we they haven’t yet formed many pathways or connections between the the two bits. It is through the process of emotional regulation described before and with the help of our parents, that these two parts start to communicate better. Of course there will always be times when the downstairs brain gets really agitated and start rumbling. But if the old and new have strong pathways, they might be able to talk better, helping us to stay calm and manage the situation we’re in. Also, because this rational part of the brain doesn’t develop fully until the mid to late 20s, it’s important that parents continue to co-regulate and ‘lend’ their upstairs brain, to help the child develop these skills. Why do we lose control of our emotions by ‘kids want to know’ provides a great summary of this to show to your kids. Why do we lose control of our emotions by Kids Want to Know - YouTube

20 Getting ready for fight/flight
Level 1 Level 2 Level 3 Level 4 Tension in hands Tension headaches Tension in arms, shoulders, neck Fidgeting Getting ready for fight/flight Dry mouth, throat and eyes Sweating Cold hands Blushing Increased heart rate and breathing Constipation Lowered blood pressure Breathing slows Light-headed Nausea and diarrhoea Urge to urinate Migraines Racing or cloudy thoughts Blurry vision Dizzy Feeling confused Hallucinating Ringing in ears Freeze/ play dead So what happens to the brain and body when we detect a threat and our emotional downstairs brain starts rumbling? When things are detected as a threat, the body produces certain physical reactions. The brain can’t distinguish objective threats from subjective threats so this can happen just as easily to being told ‘no’ as it can to hearing a loud bang. Anxiety builds in stages from the green zone, which prepares us for flight/flight to the red zone, which is our body’s response to getting caught by a predator and going limp and playing dead. Each level requires a different response and level of intervention to help us calm down and get the upstairs brain to come back online. So when the body is preparing for fight/flight then we can fairly easily access the upstairs brain but the we go further towards the red zone, the upstairs brain is likely to be offline. This means that we might need some very concrete responses such as deep pressure to calm the body down and help bring the rational brain back online.

21 Summary We all have emotions but as we age and mature we can use our upstairs brain to express these in a measured and thoughtful way This requires us to develop emotional intelligence This process is a bit like learning to catch a ball or ride a bike: at first you might drop the ball or fall off your bike but you improve each time you practice So in summary, we need to learn emotion regulation skills so that our downstairs brain doesn’t go straight to threat mode, make us panic and act irrationally. We all have emotions, but as humans and particularly as adults we can use our upstairs brains to express these in a measured and thoughtful way, that is socially acceptable and appropriate to the environment. We aren’t animals so we don’t have to just react, we can use our emotional intelligence. Emotional intelligence is what we need to be able to use emotions effectively. This is different from intellectual intelligence. People might be academically intelligent but not emotionally and vice versa. EI requires us to recognise, understand, manage and use our emotions – complex! Bringing all of these factors in line every time we feel an emotion is really difficult and takes a lot of brain power. 4 parts to understanding emotion: 1. To perceive/recognise emotion we have to read facial expressions and body language or pay attention to our own bodies 2. To understand emotion we need to understand what is causing it and why it is being expressed in a certain way, what the sensations mean 3. To manage the emotion we need to respond appropriately to the internal sensation we have and respond appropriately to others’ emotions 4. To use it we need to know what to prioritise internally and how to react and respond

22 Part 3: The challenges Of course, it’s one thing understanding the process of emotional regulation, this doesn’t always mean that it’s easy to put into practice.

23 Neurodevelopmental Conditions
Emotional Regulation is complicated enough as it is but if there are neurodevelopmental difficulties such as the ones listed here, this process can become ever harder.

24 Resulting Difficulties
ND difficulties impact on each of the factors listed on this slide Info processing – the way we’re able to understand, process and act on the info that comes into us. Inc. processing speed (how quickly we can convert what is being said to us into something that makes sense e.g. being given instructions to follow and being able to process what is being asked and then follow those instructions through). Without the appropriate interventions such as visual, step-by-step instructions this process can become frustrating and distressing for a child with ND difficulties. Interaction – difficulties in interaction are indicated in all of the diagnoses mentioned before. It is the struggle to understand others as well as to be understood – makes social interaction difficult, frustrating and potentially distressing. Self-control – This is the process of good communication between our downstairs brain and upstairs brain. Recent neuroscience research has indicated that in ASD – the prefrontal cortex has reduced activity (perhaps indicating that lids get flipped more quickly). Additionally, it is the bit of the brain that develops last – up to age 25. So even without a neurodevelopmental diagnosis, this controlling of emotions, inhibiting responses, pausing before reacting is more difficult until we’re in our twenties… Compounded for your young people if they have a diagnosis on top of it. Sensory processing – the way we interpret incoming information – senses are bombarded every moment we’re awake. Making sense of it all can be a struggle due to sensitivities present in a lot of diagnoses. This can then cause variety of problems including disrupted concentration and increased levels of anxiety. Hypersensitivity (lower threshold for sensory info) = intense and easily triggered reactions. Hugher sensory threshold (hyposensitivity) = disruptive and disregulated behaviour.

25 Emotional Reactions are Quick
Part of the problem with being able to regulate our emotions is that emotional reactions are quick, and quicker than our thoughts. Our brain is wired to look for threats or rewards. If one is detected, the feeling part of the brain quickly responds with the release of chemical messages, which travel through the body – these are our emotions. Detection of threats release adrenaline and cortisol, which prepare us for fight or flight. Detection of rewards release dopamine, oxytocin or serotonin, which feel good and motivate us. Release of these chemicals is quick and automatic and this is important to keep us safe and protected. If we were in front of a bear waiting for our thoughts to kick in and decide what to do for example, this probably wouldn’t end well. Our emotions help us to respond quickly to keep us safe. Whilst this is great in certain situations, it can cause problems in others. Because the feeling bit kicks in first before the thinking bit, particularly if the feeling is very strong or overwhelming, it can prevent us from thinking rationally in the moment when there isn’t a real threat. So we respond with fight, flight or freeze and our lid is flipped before we even know what’s happening. Our emotions basically hijack our brain and stop us thinking rationally. For further information about this, watch the sentis brain animation series - emotions and the brain

26 Experiences can cause ‘Threat’
To make it even more complicated, as well as the immediate detection of threat or reward when dangers are presented to us in the here and now, we can also learn through life that something produces a threatening or rewarding response. Our experiences get paired with an emotional memory and we learn that something is either good or bad; so every time that experience reoccurs, either threat or reward chemical messages get released based on our learned interpretation of that event. For every experience we have an emotional response, linked to our experiences. This will impact on our response to the event which can perpetuate the situation. e.g. If we are attacked by a dog when we’re younger, our emotional brain will link that memory of a dog attack to the emotion of fear, which is activated every time we see a dog. Since our FFF response is activated, we might therefore avoid dogs in the future, which means we never get the chance to disprove our belief, and we get stuck in a pattern of believing the dog is frightening. The important thing to remember if that the body responds in the same way to objective threats such as snakes and bears as it does to things that might not actually be life-threatening. If you’ve learned it’s a threat, the same process occurs regardless and the same parts of the brain start firing. This might be ‘let’s go to school’, ‘get in the shower’. This can create a sense of being out of control and when that threat is detected, it will be hard to pull back because emotions start firing so quickly.

27 Different interpretations cause problems
Another problem can arise when people have different interpretations of the same problem, leading to conflict. As stated in the previous slide, past experiences link to emotional memories and interpretations, and this might be different for each person. So for one person, a shower may be an ordinary and pleasurable thing. For a child for sensory difficulties however, they might have learned that it is uncomfortable, painful even. Thus when a request is made for them to have a shower, they experience a flood of threat messages, leading to an extreme emotional response. If the parent in this situation does not remember that experience affects interpretation and response, they might be prevented from perspective taking, and simply see the child’s reaction as ‘you’re making a problem for me’.

28 Always remember that your child’s behaviour is simply a communication of their emotions. If you can stop and think, you can use your well developed brain to help out your child, respond in a rational way, and take into account their perspective. Be curious about their behaviour and try to understand their interpretation and point of view. By re-considering your interpretation, you are more able to lessen the chances of conflict and escalation; and find your way out of a repeating unhelpful pattern of thinking or behaviour.

29 Part 4: Strategies So what are some of the ways that you can help, to support your child’s emotional regulation?

30 Change is Possible A key point to remember is that change is possible. Even though emotional memories form quickly, our brains can learn new ways of thinking and reacting. We can disconfirm previous experiences, so if your child currently struggles with regulating certain emotions or reacts in a certain way to certain experiences, this doesn’t mean it will be like it forever. This process is called neuroplasticity. We all have habits, ways of doing things in a certain way. These pathways or ‘roads’ in our brain will be strong and easily accessible, a bit like a well trodden track in the forest. However we can always decide to take a new path and in time this new path will start to feel safe and familiar too. As we start to use this new path, the old path will become overgrown and unnecessary. We might need a bit of encouragement at first, the promise of a reward at the end of the new path. But since reward pathways in the brain are strong and feel good, this can speed up the process of learning. This is why reward charts, praise and encouragement rather than criticism or discipline work better to encourage learning. Sentis brain animation series – neuroplasticity

31 Strategy 1: Proactive Before Reactive
When we’re thinking about how to support children with emotional regulation, it’s important to remember that proactive strategies are always preferable to reactive strategies. This is because if you plan in advance, you keep the brain in a rational and flexible state rather than trying to communicate with the irrational ‘threatened’ part of the brain. Proactive strategies are preventative and can be used throughout the day to help maintain a well regulated state. Family life – predictability is important so that they know what to expect and when to expect it (this can’t be for every eventuality but a consistent degree of predictability – it might be that there are bedtimes for term time and bedtimes for school holiday times etc.) House rules can help to manage expectations – so that the child knows what is within and outside the boundaries in terms of behaviour. Fairness explained as ‘people are treated the way they need to be treated’. You wouldn’t treat a 2 year old the same as a 10 year old in terms of discipline as their developmental stages will require different strategies. Likewise, in terms of a child with a neurodevelopmental diagnosis and a child without, the difficulties they experience (as mentioned before) will dictate that different strategies and approaches are required. Emotions – use your own empathy – so really putting yourself in their shoes. ‘If I were my child in this situation, how would I be feeling?’ Their worries might not make sense to you but you can try to see them from their perspective. Accepting their emotions but not necessarily the behaviour – it is real to them. So a meltdown over a ‘trivial’ matter – can empathise that they are feeling upset but let them know that it is not ok to hit out at others. Being a good role model – so trying to keep your pre-frontal cortex online! If you want them to stop shouting, you probably need to stop shouting… Sometimes talking out loud can be helpful for them to learn how you’re managing your emotions e.g. ‘I am starting to feel really cross about this, my heart is beating quickly and I can feel my mouth getting dry so I am going to go to the other room and count to 10/take some deep breaths/step outside in the fresh air and wait for my feelings to calm down a bit’. Challenges – breaking experiences down in terms of forward planning (trip out – where will be going and who might be there), explain it but don’t be drawn into repeating over and over and over. In a developmentally appropriate way you can coach them to take some responsibility in this so for example you might explain something a maximum of three times but after that direct them to a written explanation so they can check it out for themselves. When they are facing a challenge it is about offering support through it. Think about learning taking place over time – people need to be supported in different ways at different times. Child will learn from experience – so experiences of success can be drawn on to encourage further learning.

32 Strategy 2: Recognising how emotions feel in the body
In order to be able to regulate emotions we also need to learn how to recognise emotions. You can model this for your child. Help your child to identify how strong emotions (happiness/anxiety/sadness/anger) feel in their body and plot them on a blank figure so they can begin to recognise the physical signs with the change in emotional state… All emotions have a physiological response in the body and familiarising yourself with these responses can help you model and teach this for your child.

33 Feeling hot in the face - turning red
Clenched jaw Rapid heartbeat Increased body heat Feeling hot in the face - turning red A sense of pressure building up inside Feeling empowered and strong Arises in waves Anger for example…

34 tears or increase in tearing sensation of heaviness in the chest
heaviness in face sensation of pressure behind the eyes engorged eyelids and redness around eyes subtle changes in facial expression touching around or rubbing the eyes voice can become lower and scratchy quiet crackling sounds in throat or swallowing Sadness on the other hand…

35 Warmth or an upward moving energy An urge to reach out and embrace
An urge to smile An urge to touch or hold the other person Eyes widen An expansive feeling in the chest A sensation of calm And finally joy, happiness or connection can present by… Begin to notice these sensations yourself so you can have emotion focused conversations with your children and encourage them to focus on their own internal experiences

36 Strategy 3: The incredible 5 point scale
How does this feel? What makes me feel this way? How can I tell? What helps? 5 I could lose control! School bells The loud talking and laughing keep going Too late!! I am screaming! Stop talking. Close eyes. Deep breaths. Quiet room. 4 I feel really upset and shaky. When I make a mistake or people laugh at me I start swearing out loud. I say mean things to other people. I tear up my work. Take a walk out of the room! 3 I feel tense and nervous People are talking loudly or laughing. When chairs scrape on the floor I say shut up really quietly. I start staring at the people talking. Take my time out card to teacher. 2 I feel a bit bothered and a bit tense When I can’t have my turn straight away I start repeating the TV schedule, I get a bit twitchy Breathing and distraction – do something else 1 I feel really calm Watching TV or playing XBox My brain feels relaxed, I am smiling and look happy Once your child recognises how their body feels when they feel certain emotions, it can then be helpful to try and identify what your child’s possible triggers are, help them to identify situations that impact on their emotional state, what this looks like and how they and others can help to keep them calm. Starting at number one where they feel calm/soothed/happy… Moving up, the child can think about what the situation is, what the emotional state looks like for them, what it feels like and what they or others can try to do to improve their reaction.

37 Potential to re-trigger
1 Calm 2 Alert 3 Alarmed 4 Fearful 5 Terror/Crisis Recovery period: Potential to re-trigger Post crisis blues Finally, it can be helpful to understand your child’s emotional reactions on the anxiety curve. This is something you can share with other key adults and teachers to help them understand your child’s emotional reactions and how to intervene. The anxiety curve acknowledges the fact that distress happens in stages – the build up (rumbling) stage, the meltdown and then recovery. Of course these stages might escalate rapidly, or there might be a slow build up between stages. The first stage is when you’re completing calm. Between 2-3 is when emotions are building. This can be a time to try to comfort or try to understand your child’s needs, to see if you can help them solve whatever problem is causing their distress. Their downstairs brain is rumbling here but they still have access to their rational brain and it could still be possible to intervene. This is where your child’s individual positive strategies will need to be used (could be a social story to aid understanding of the situation, a calming sequence, yoga, breathing etc…) Further up the stress scale, that old brain starts rumbling more and more, which of course affects your child in a number of different ways. When your child has reached a 5, you can liken this to them ‘flipping their lid’ and have little input from their thinking and rational new brain. Their position on the curve ultimately determines how you respond to them. If they still have access to their new brains, that you can use words and help them understand what is happening to help them feel understood and calm down. If they reach a 4 or 5 however, they will have limited access to this more rational connected part of their brain. A final point to remember is the recovery phase, where there is the potential to retrigger. Ultimately, they are still at a 3 or a 4. There can also be a post crisis blues where the guilt and shame may arise and they need you to be there to reconnect and allow them to process this experience. In considering the stress curve, it is important to think also about the dotted line. The dotted line is you. Understandably, as their feelings increase, you might have your own emotional reaction and your feelings might rise too. You can plot your own curve underneath as when our children respond emotionally, we do too. It is helpful to think about what situations fire up your old brain and learn what you can do helpfully at each point.

38 Summary Emotions are normal feelings which we gradually learn to control and regulate Neurodevelopmental problems can impact on the extent to which children can regulate their emotions As individuals mature however and with the right strategies, it is possible to develop effective emotional regulation skills Anger will always be with us but healthy expression comes in the form of assertion rather than aggression or violence

39 https://dimensions.covwarkpt.nhs.uk/
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