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  • Dr Chris Moore

Compensate for my Brain State: The Arousal Continuum

From undertaking the “Introduction to the NME Training Series” and having read much of Dr Bruce Perry’s work on trauma – including his seminal book “The Boy who was Raised as a Dog”, I’ve always been struck by two types of dependency when we think about brain development.

First, brain systems are “use-dependent” – a system which is activated more often will undergo further change than one which is exercised less frequently. It’s much like focusing on only one muscle group in your gym workout – your other muscles won’t be as strong. The brain develops sequentially from the bottom up. Ideally, patterned and repetitive experiences delivered through nurturing and attuned relationships help a child to develop an effective stress-response system. Healthy interactions with an attuned and sensitive adult enable the child to - as Dan Hughes said during my DDP training - “feel and deal”; to develop the means of regulating their emotions and cope with stressful demands and unfamiliar challenges.

If a child has been exposed to prolonged and unpredictable stress, or more traumatic circumstances, this fundamentally alters how the brain’s systems develop. The lower parts of the brain which govern responses to anxiety and fear receive a more comprehensive work-out over time. This is because they are needed to help the child survive regular threats to their safety and well-being. Meanwhile, the higher parts associated with impulse control, reflection and rational decision-making receive less exercise. Therefore, they are harder to access when the lower parts of the brain are switched on.

The brain is also “state-dependent”. How we respond to an event depends on our physiological state at a given time. A child who can more easily maintain and return to a calmer state will be better able to learn new academic concepts and skills. They will also be better equipped to manage social interactions and cope with change and transitions. Such functioning is far more difficult for a child who has experienced frequent and significant stress. Their response will be more often governed by the primitive, survival-focused parts of the lower brain. This is why a new learning activity, a change in routine or seemingly minor events can elicit an unusual and even distressed reaction. These children are more likely to have stress-response systems which are highly sensitised and over-active.

Dr Perry has outlined five different states which we shift between, depending on the signals we are receiving from our body and the outside world. The following is a brief summary of this “arousal continuum” from the perspective of a child.

Calm

“I feel safe and comfortable. The top part of my brain is working well to keep my feelings regulated. I can think in more abstract terms about what you are teaching me and I am open to curiosity and reflection. I can consider the past, present and future. I’m able to plan ahead and think rationally about the cause and effect of different actions”.

Alert

“I’m thinking in more concrete and less creative terms about what you are teaching. While I’m less able to engage in reflection, I am interested in how others are reacting to the same information and input. My sense of time is narrower and I can consider the hours and days ahead. I may be a little nervous about something new or unfamiliar, but I can be reassured by structure, routine and supportive words”.

Alarm

“My breathing and heart rate are getting faster and my muscles are tensing. I can’t store and process information very efficiently and I’m finding it much harder to focus. You may see a change in how I speak and how I move. It’s harder for me to think rationally. I can talk about the past, but the present is just hours and minutes to me. I’m more sensitive to how you look at me, your tone of voice and your posture. I need you to be curious on my behalf and model how to calm my thoughts and feelings”.

Fear

“I’m now very reactive to my surroundings and more prone to fight, flight and freeze. My sense of time is restricted to the next few minutes and seconds. I am feeling so overwhelmed. I won’t easily trust your suggestions or understand consequences. I may refuse to do what you say or look for a chance to escape what is expected of me. I really need you to accept how I feel and show that you understand; my behaviour may seem irrational, but right now I’m just trying to survive”.

Terror

“The bottom part of my brain is completely in charge. I have no sense of time; no sense of where I am or what I’m doing. I’m not really thinking any more. You’re seeing my reflexes; the instinctive desire to confront or retreat has consumed me. I may be very still or I could be rocking back and forth. If you come too close, I might lash out or run away. I need you to keep me safe. It’s going to take time for my terror to subside”.

Given that a different part of the brain is in charge of these various states, we really need to be mindful of where the child might be within this arousal continuum at any given time. This has many implications for supporting stress and implementing trauma-informed practice within the classroom.

1. All teaching inherently involves activating a stress response. We are exposing the child to something new after all and this learning can be later retrieved through the creation of memory. It’s ok if they appear temporarily distracted, fidgety or disengaged; there is a frequent shift between the Calm and Alert states as the incoming information is mixed with existing knowledge. Ideally we seek to find the arousal sweet-spot – teaching which is sufficiently engaging, motivating and challenging, but not overwhelming.

2. A child with a history of adverse experiences will have a much greater sensitivity to stress. The Alarm state may in fact be the default for some children and they will therefore descend into Fear far more quickly. Our teaching simply won’t reach the higher parts of their brain while they are emotionally dysregulated and unable to tolerate even minor challenges. Increased structure and differentiation will help to mitigate the anxiety about new tasks and less familiar routines. Repetitive opportunities to practise new academic concepts and skills will be essential in promoting familiarity and gradually increasing the level of challenge. We also need to schedule down-time and periods for revisiting and reflecting on the teaching content.

3. A punitive approach to behaviour will be useless when the child has regressed to a younger level of functioning, unable to consider cause and effect and make connections between behaviour and consequences. What will a reward or sanction mean for a child who can only think two minutes ahead and not to the time when a privilege is earned or revoked? Dr Perry’s 3 Rs of Regulate, Relate and Reason offer a more appropriate sequence of engagement. We need to start with the senses – regulating the body and brain through movement, dance, art, music, breathing and grounding. We also need to increase the frequency of nurturing and empathetic interactions; conveying our compassion, our curiosity about what a behaviour is communicating and our willingness to help. We can be therapeutic without being therapists.

4. Just as children who have experienced a high degree of fear and stress are hypervigilant about potential threats, we need to actively observe the signs which indicate that a child is shifting down the arousal continuum. This involves noticing changes in their tone of voice, their physical movement, their emotional reactions and how much help and reassurance they are seeking, This is also why it’s important to teach children about emotions – their names, how they feel in the body, what they look like in our actions and the associated thoughts. Providing a language for feelings and a means of communicating them – through words, gestures and visuals – will help children to gradually detect changes in their state before the higher parts of their brain are sealed off by their stress-response.

5. In order to be a source of safety, comfort and reassurance, we need to keep track of our own brain states. There’s lots of references to self-care and looking after yourself on social media; such messages simply cannot be overstated. If we don’t make time to indulge in activities which help us feel calm or appropriately alert, we will struggle to help children regulate their own emotions. We will find it harder to understand and tolerate the behaviour associated with their powerful thoughts and feelings. Now is the time to consider your own plan for stress management – identify the activities which are relaxing and rewarding, connect with people who are understanding and supportive and forgive yourself when you occasionally struggle to keep up with the demands of an ever-changing and hectic world.

References and Further Reading

Bomber, L.M. (2020). Know Me to Teach Me: Differentiated Discipline for those recovering from Adverse Childhood Experiences. London: Worth Publishing Ltd.

Golding, K.S. (2017). Everyday Parenting with Security and Love: Using PACE to Provide Foundations for Attachment. London: Jessica Kingsley Publishers.

Gudbjartson, L. (2018). The Green, Yellow, Red Approach: Incorporating Neurosequential Model Principles into Private Practice. In Perry, E.T., Griffin, G., Maikoetter, M., Graner, S., Rosenfelt, J.L. & Perry, B.D. (Eds). Proceedings of the 2nd International Neurosequential Model Symposium. Houston: The Child Trauma Academy.

Meredith, M. (2020, 16th May). Towards a pastoral pedagogy fit for the pandemic age – a final reflection on The Boy who was raised as a Dog. https://marymered.com/2020/05/16/towards-a-pastoral-pedagogy-fit-for-the-pandemic-age-a-final-reflection-on-the-boy-who-was-raised-as-a-dog/

Perry, B.D. (2020, March 23rd). 1. Patterns of Stress & Resilience: Neurosequential Network Stress & Trauma Series. https://www.youtube.com/watch?v=orwIn02h6V4

Perry, B.D. (2020, March 26th). 2. State-Dependent Brain Functioning: Neurosequential Network Stress & Trauma Series. https://www.youtube.com/watch?v=PZg1dlskBLA

Perry, B.D., Pollard, R.A., Blakley, T.L., Baker, W.L. & Vigilante, D. (1995). Childhood Trauma, the Neurobiology of Adaptation, and “Use-Dependent” Development of the Brain: How “States” become “Traits”. Infant Mental Health Journal, 16 (4), 271 – 291.

Perry, B.D. & Szalavitz, M. (2017). The Boy Who Was Raised As A Dog: And Other Stories from a Child Psychiatrist’s Notebook (Revised and Updated Edition). New York: Basic Books.



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