Alternative to Behavior Modification

Post-Institute-alternative-to-behavior-modification

A number of leading mental health professionals in the field today as well as in the past have advocated for the child to take responsibility for her actions. This has implied that if the child does not take responsibility there will be a resultant consequence. Indeed this is perhaps the most commonly recommended course of action for parents to take in working to overcome their children’s problem behavior. This is most commonly mislabeled as a “natural” consequence. Wherein upon making a mistake or the wrong choice the child is forced with the outcome of their inappropriate behavior having to deal with the parent imposed consequences. These parent imposed consequences related to the misbehavior have been mistakenly labeled “natural.”

Natural consequences do exist. They are apart of experiential life for everyone. The form of consequences advocate by mental health professionals are not at all natural but in fact parent formulated. The parent is instructed to engineer a consequence for the demonstrated behavior that in turn is to become a learning experience for the child and future detour to behavior. Natural consequences are not engineered, they occur whether we like it or not. If we miss work as adults we do not get paid. If a child trips while running, the natural consequence to the running is to fall. If the electric bill doesn’t get paid, it gets turned off. These are real life natural consequences. Natural consequences are not engineered by others, they are a naturally occurring part of life.

The difference between a natural consequence and a parent formulated one is that one is natural and the other is not. Parent formulated consequences attempt to teach a child a lesson he is generally unequipped to handle and will seldom understand. The parents first response is that of, “If I don’t teach them consequences how will they learn?” What we fail to understand is that in our obsession to teach our children consequences and responsibility, we are also failing to teach them genuine empathy, responsibility, and obedience.

One commonly recommended approach by mental health professionals to parents to help overcome a child that seems unwilling to think, answer, or verbalize the appropriate response by continually saying, “I don’t know,” is to give jumping jacks as a consequence. In this example a very insensitive interaction is occurring. First, the parent has determined that this child willingly is not responding or answering the question asked. In other words, this child has full conscious ability to answer when spoken too! This is a common misconception. Findings from the field of neuroscience have quite clearly been able to demonstrate that during times of overwhelming stress the normal cognitive functioning aspects of the brain become overwhelmed by the hormonal stress outpourings created in the brain. In this capacity the emotional neurophysiological response far exceeds the ability for cognitive-rational decision making and processing. In this manner, when a child with a history of trauma is exposed with the threatening situation of having to respond to a question, she may become overwhelmed with her own neurophysiological stress response, therefore “literally” rendered unable to answer in the “appropriate” manner. Hence, the response, “I don’t know.”

The Stress Model relates this behavior more directly to the actual neurophysiological stress presence preventing the appropriate response. In the moment of stress and being questioned it is likely the child actually does not know why they have behaved in a particular manner.  Added to this, neuroscience explains that for all of us, a majority of our behavior and interactions are acted out from the subconscious. Therefore, to force the child to do jumping jacks to “get the blood to his brain” is to ignore and neglect not only the emotional presence of the child, but more importantly the stress being demonstrated.

We have been led to believe that children that have suffered trauma and generally have been labeled as Reactive Attachment Disorder are inherently difficult children without a conscience or empathetic development for others. How does a child, made to do jumping jacks because of not being able to answer appropriately, be expected to develop any degree of empathy for others? He cannot, it is physiologically impossible. The very eloquent Stephen Covey stated, “Unexpressed feelings never die. They are buried alive and come back later in ugly ways.” In other words, the battle is won at the expense of the war! The battle being the often repeated and varying behavior and the war of course is the stress. This paper explores and expands on the The Stress Model Theory and how it is the center of focus in the Family-Centered Regulatory Parenting approach.

Understanding The Stress Model

Family-Centered Regulatory Parenting is a model of parenting based on The Stress Model theory of behavior that attempts to explain the underlying causes of behavior in children. In order to thoroughly explain this new alternative to parenting and why parent formulated consequences are not effective, a theoretical foundation for The Stress Model must be presented initially.

The Stress Model states, “All behavior stems from a neurophysiological state of stress (dysregulation) and in between stress and behavior there lies the presence of emotions. It is through the expression of emotions that we gain access into both behavior and stress. Through emphasis on the effective expression of emotions, parents can foster the environment necessary to calm or regulate the neurophysiological state of stress and diminish the demonstrated behavior.”

What we must understand is that it is our early socio-emotional environment and interaction with significant caregivers that establishes our future self-regulatory capacities. Regulatory capacities are our ability to successfully navigate emotional states such as anger, sadness, fear, or hurt, and furthermore, our ability to establish and maintain relationships. This is done through the successful maintenance of stress within a safe operating range. For example, the race car driver who becomes angry in the midst of a race because he has been cut off by a lead driver causing him to miss an opportunity to take first place, becomes overwhelmed with anger, stomps on the gas pedal and rams the lead car out of the way. However, through successful emotional regulation, the driver maintains his focused emotional state and waits for the next opportunity to take the lead while being fully aware that the lead driver may once again attempt to cut him off.

During vital interaction with caregivers and the nurturing environment primarily from conception to age 33 months, the developing system is directed towards effective self-regulatory ability. For instance, in the classroom setting, the kindergarten student embarking on his first school/social learning experience is directed through his experience primarily through the teacher and secondarily, by the students of which he will interact. If the teacher is a miserable incompetent who demonstrates little concern for the education of the students and lack of control of the classroom environment, the student will fail to meet his educational needs. To the point of this paper, if a child is the recipient of inconsistent and ineffective care, i.e. unmet needs, provided by the parent, the child will not develop the necessary skills for effective emotional regulation. Fundamentally, The Stress Model assumes that a child witness to chronic ineffective care of a primary caregiver is also the direct recipient of ineffective teaching of the regulatory system. Primarily because an ineffective parent with minimal ability to provide the necessary parental ingredients such as attention, affection, and attunement, is generally overwhelmed with their own chronic state of stress. For example, the drug-exposed infant is the recipient of exposure due to the mother’s attempt to alleviate her dysregulation via drug consumption. It is not the intent of the mother to damage the developing fetus but rather her attempt to deal with the stress in her own physiological system. The abused wife’s lack of concern for the proper care of her children is not intentional, it is her chronic state of stress induced fear and depression related to the looming threat of the abusive husband returning for yet another violent episode. With the stress of this constant threat the mother is rendered near helpless in consistently meeting the needs of her own children because she lacks the internal state to function successfully.

Relevant Theoretical Considerations

It is yet to be fully understood how the developing regulatory system processes the input that it receives. The Pavlovian school of thought states that through repetitive interaction the body is conditioned to respond in a certain manner, however, the Control system school of thought expounds the idea that the brain/body system has a memory and natural drive towards pleasurable states and in some manner forms pictures or cognitive and physiological associations to what is and is not pleasant. The Stress Model assumes that to a degree both schools of thought have some validity. We now have evidence that suggest that over a period of time we become accustomed to respond to certain stimulus in a set manner with minimal cognitive control. This suggest both pavlovian conditioning and pleasure seeking. Not only does the body become conditioned to respond in a certain manner, but there may also be a degree of remembrance of experience from which the physiological system calls forth and seeks a relationship between present and past experience. For example, the small toddler, when unattended, immediately runs to the kitchen, devours half the frozen pizza sitting on the counter top prior to lunch and quickly takes the remaining portion and strategically places it under the rug next to the lamp. In this situation the toddler, suddenly triggered into a state of stress, stuffs unpleasant food in his mouth due to a conditioned learning of not having food needs met in a timely and consistent manner. Furthermore, the directed attempt to hide the food is based on the remembrance of hunger appearing and food not being present, therefore the picture of pleasure is one where food has been successfully stored waiting for the hunger to reappear. In any instance, the fundamental trigger is the stress and through the triggering all manner of associations occur which lead to the eventual behavior.

For the child who has suffered a history of trauma, this is of specific importance because this child has not nearly developed the necessary regulatory tools for navigating the emotional states which subsequently lead to the problem behaviors demonstrated. As stated earlier, it is the environment of attention, affection, and attunement that leads to a positive regulatory learning experience for the child. In other words, it is the environment with well regulated and modulated stress occurrences that will communicate to the child the lessons for his own future emotional navigating abilities. The number of factors contributing to exposure to chronic stress is too immense to list. Each individual brain responds and reacts to trauma and stress in a different way, however, common causes to chronic stress are abuse, exposure to drugs, neglect, abandonment, inconsistent care, adoption, frequent foster placements, or any other highly stressful event as common as birth trauma, automobile accident, or loss of a parent figure. In this regard, the exposure to chronic stress does not allow one the capacity to develop effective regulatory processes. Generally, as stated previously, this has occurred during the first 33 months of life and has become an engrained and firmly established pattern in the child’s regulatory system. Rather than having assimilated positive learning experiences, he has assimilated negative experiences. Therefore, in later social and emotional interaction such as with the toddler, the actions demonstrated are negative rather than positive.

Making the Necessary Connection

The two areas of significance we have failed to understand until recently concern the connection between the neurophysiological (brain/body) system and its interaction with the rational/ cognitive (psychological) functioning of the brain and how this interplay ultimately leads to one center having more impact on behavioral outcome than does another. The two control systems in the brain, the left and right hemisphere, though connected, are responsible for two very different duties. The left brain is our center for rational/cognitive processing and functioning, our right brain controls our social and emotional functioning. In other words, the regulatory capacities demonstrated by a child are not engrained patterns set in stone from which he is able to make fully rational and cognitive decisions. Though the two centers work in conjunction with one another, it is ultimately the right brain which determines the manner in which the left brain will act. For example, in a state of fear, a student generally very capable at answering a mathematics question will blunder the question due to the presence of dysregulation from the right brain. Or, in times of extreme anger and shame, the bullied teen goes on a shooting spree killing twelve students in a school and then turning the gun on him self. In this example there is no healthy rational/cognitive process at work but rather a reaction based on the stressed communication of the right brain. In the presence of stress the failure to effectively navigate emotions leads to minimal ability to navigate cognitively or rationally.

Contrary to the adult, the child will continue to demonstrate an immature regulatory state throughout their development. It is the constant interaction with the primary caregiver and the nurturing environment that leads to a successful outcome for self-regulatory ability. In further investigation and recent findings it has been demonstrated that the right brain control system responsible for effective self-regulation is also an area of the brain which remains open to change throughout the lifespan. However, in order to effect the change, the key ailment, stress or dysregulation, must be alleviated.

Therefore, when The Stress Model states that all behavior stems from stress; the use of consequences is not an effective tool for short term altering of behavior and long term development, it is essentially reiterating the fact that children, primarily children of trauma, are reacting from a neurophysiological state of which they only have the power to demonstrate the most minimal degree of control imaginable. If a child is behaving inappropriately, he is not merely behaving inappropriatly but rather is behaving out of a state of neurophysiological upset or stress. In order for parenting intervention to be effective for long term developmental change and immediate behavior alteration the parent must approach the behavior from the perspective of The Stress Model in that the emotions must be expressed in order to calm the stress and diminish the behavior. Otherwise, to give consequences for behavior is merely consequencing behavior and is not addressing the underlying developmental ailment and cause of the behavior. In many ways this alternative approach is a preventive approach because it is working to create the necessary environment for the emotional regulation of stress. Setting the neurophysiological stage to correct what the child’s regulatory system has learned and experienced.

Previously, Family-Centered Regulatory Parenting states, ” The use of consequences is not an option in the Family-Centered approach due to the principle that the primary caregiver must take responsibility for the developing child. In doing so, inappropriate behavior is a warning sign that the child is exhibiting a conditioned stress response and it is the responsibility of the care giver to initiate a learning and safe environment for the at risk child via containment. Within the application of the Family-Centered Regulatory treatment model a system of application is geared towards prevention of upset emotional stress and behavioral acting out rather than intervention. Through the overall process of the Family-Centered approach, the very act of parental responsibility begins to initiate the most valuable behavior modifying technique available. The dyadic transactions, which occur between the caregiver and child, create the environment for restoring the lost nurturing and attunement, which created the child’s overly, sensitized stress response system in the beginning. In this manner the parent offers the most advanced system for child intervention available because the overall schema of treatment is not merely geared toward behavioral intervention, but towards the neurophysiological underpinnings of behavior itself and the parent-child dynamics that create stress.”

Successful Formula for Stress

To this point it is now appropriate to introduce The Stress Equation which is yet another vital tool and aspect of the Family-Centered approach which is often overlooked in past and present parenting approaches.

The Stress Equation:

A+B+C1=D1 (Regulation)

A+B+C2=D2 (Dysregulation)

Variables:
A Parent
B Child

(C1) Calm

(C2) Stress

(D1) Regulation

(D2) Dyregulation

In continuation of The Stress Model within the Family-Centered Parenting approach, it must be understood that the entire family can be and is affected by the stress of another family member. Remembering that the parent is the primary responsible party for the effective teaching and regulation of stress, it must therefore be understood that the parent(s) are always a part of the final family regulatory state. When implementing The Stress Equation, we can utilize the following situation as a classic example. A father comes home from work stressed out after having been fired. This physiological state is immediately intrudes upon that of the wife and ultimately the child. Being that a child is immature to the parent in all areas, he will generally be the one participant in the home and variable in the equation that acts out the stress through behavior more so than anyone else. In this manner, the child generally becomes the stress target for the rest of the family. In a family of more than one child, the child with the least independent regulatory ability will become the target because he will be the one individual in the midst of the environment the least capable of regulating the stress therefore causing him to act out the most. For this reason, it is generally the child that brings the parent(s) into treatment. On various occasions, it is not only the child in need of the treatment it is the parent(s) as well. In this regard, successful treatment outcome is impossible without the inclusion of the entire family. When we implement these variable into The Stress Equation the following occurs:

A(parent)+B(child)+C2(stress) =D2 (dysregulation); The family and specifically the child are in a state of dysregulation. In this instance the child is screaming and very hyper, therefore the father immediately imposes a very harsh consequence onto the child.

Subtract B (child) from the equation and you are still left with both C2 (stress) and D2 (dysregulation). Not only has the underlying cause of the behavior not been dealt with but it has been forced upon the child as the problem.

In this same situation in order for the outcome to be positive, the stress (C2) must be subtracted in order for the family to restore their systems to a positive state:

The father comes home and says to the wife, “I’ve been fired.” Undoubtedly the stress will remain high within the family unit but when the child begins to act out the parents will be attuned to what could possibly be the first cause of the behavior. In doing so the parent(s) will first address stress (C2) before immediately eliminating the child (B) because of the demonstrated behavior. In doing so, the parent(s) are first, taking responsibility, and second, eliminating the stress (C2) from the family equation so that the underlying cause is acknowledged and effectively dealt with. When The Stress Equation is completed with a positive outcome, the underlying ailment in the family setting is contained as a unit, the family is restored to regulation, and the child with the immature regulatory system is modeled yet another positive experience in which to begin to establish the needed self regulatory ability.

Conclusion

In conclusion, ultimately it is the regulatory ability that leads to our success as individuals in society. Unfortunately to many parents themselves lack the mature regulatory system to be effective regulatory teachers to their children. The parents therefore seek professional help and the professional often times enhances the state of dysregulation by being child behavior-centered. When this is occurring the child is often blamed, labeled, and the behavior given repeated consequences, in worse case scenarios, the behavior is medicated or the child begins to act out to such a degree that he is placed in residential treatment. As long as there is not a parent willing to take the responsibility to communicate the necessary regulatory lessons, the child will not develop the necessary effective regulatory skills.