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Regulate, Relate, Reason
by Jen Sims, Clinical Director
A couple of years ago I had the fortune to attend the International Play Therapy Conference and hear Dr. Richard Gaskill speak about the ‘Neurosequential Model of Therapeutics’ (NMT). This is a concept developed by Dr. Bruce Perry, who has had some notoriety in the past few years due to his book with Oprah Winfrey, “What Happened to You? Conversations on Trauma, Resilience and Healing”. The basic idea behind NMT is that if a person experiences traumatic events at certain developmental stages, our therapeutic healing interventions should be directed toward that developmental stage as well.
All humans experience regression at times, shifting back developmentally as a reaction to stress. When this happens, we need to meet ourselves - or be met - where we are at until these feelings are resolved. But what about when something extraordinarily stressful occurs, something that can disrupt the progress of emotional and physical growth?
Our brainstem/cerebellum is the part of the brain that manages temperature, heart rate and blood pressure – something that should be perfectly regulated in the womb and then by the caregiver after birth. This is basic survival. Our mid brain – the diencephalon and limbic systems - regulates our appetite, feelings of safety, fear and attachment/relationships. Finally, we get to the pre-frontal cortex, the part of the brain that gives us concrete reason and logic. Even when these parts of the brain develop fully without issue, we may hold or rock ourselves when in distress – going back to the needs of the brainstem. When extreme or traumatic stress is experienced while these areas of the brain are in development, it can deeply impact someone’s ability to cope.
I have to tell you that I am not an expert on the brain. In depth information about Bruce Perry’s Neurosequential Model of Therapeutics (and the school-based adaptation, Neurosequential Model of Education) is easily available online (links below). There is much to learn about therapeutic treatment for traumatic events using this method. However, this process can be generalized to everyone if we remember the basics: Regulate, relate, reason. This is a hierarchy from the bottom of the brain going up – relationships happen when we are regulated, and reason can be accessed when we are in safe relationships.
Have you ever tried to learn a new skill when you are under stress? It is much harder as our IQ levels can drop as much as 30 points when the pressure gets too high. All the skills that we have learned go right out the window. Before anything else happens, we need to be regulated - but how? Dr. Bruce Perry recommends somatosensory activities to calm down. These are repetitive and rhythmic interventions that target the brainstem – such as walking, rocking, swinging, tapping, and music with rhythmic beats. Children especially need a regulated parent/adult to lead this effort.
Once the brainstem is calm, we are able to connect through relationship. This is the time to use empathy and reflective language to ensure that that the person or child you are with feels seen, heard and understood. You can say things like, “You are safe,” “I am here,” “I love you,” “You are so angry,” “That felt so unfair,” and so on.
After the body is regulated and connections are made, a person may suddenly be able to remember all of the skills that they already knew – breathing, counting to ten, walking away, writing in journals, talking to a friend. A parent might think, I already taught my child all of these skills, why didn’t they just use them when they were so upset? This is why! This is also the state that someone needs to be in for any new learning to occur.
How does this fit in with Play Therapy? The non-directive approach of play therapy matches concept of regulate, relate, reason perfectly as it allows a child to be in a regulated state of existence during sessions. A therapist works alongside a child to provide attunement, empathy, and reflection in the safety of a strong relationship. At that point, the child’s pre-frontal cortex is open for business and ready to learn new things – either intrinsic or extrinsically.
The next time you, someone you know, or your child experiences dysregulation for any reason – remember the 3 R’s: Regulate, relate, reason!
For more information about NMT:
Jen received her Registered Play Therapy Credential!
After several years of study, direct service and supervision, Jen Sims recieved her credential as a Registered Play Therapist ™. This means that she can officially call herself a 'Play Therapist' and continue to provide the highest quality of service to clients of the Redwood Center for Children and Families
A Play Therapy podcast - for parents!
Check out this podcast by Dr. Brenna Hicks - she offers parening tips and advice from the persepctive of a Play Therapist. You can find this on Spotify, or wherever you listen to your podacsts!
April Book Recommendation
Many parents ask how can I help my children become strong and resilient. This book by Peter Levine and Maghie Kline addresses that issue head on in "Trauma Proofing you Kids: A parent's guide to instilling confdence, joy and reslience." We can't prevent bad things from happening, but we can help our children to become strong enough to withstand storms. We have this in our library at The Redwood Center if you would like to have a sneak peek.
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