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  • Writer's pictureDr Chris Moore

Relational Routes: Part 2 of the 3 Rs

In my previous blog, I wrote about part 1 of Dr Bruce Perry’s sequence of engagement (Regulate-Relate-Reason). Regulation should always be our starting point when we feel that the child’s arousal levels restrict access to higher level thinking and reflection. This blog will explore some ideas for the second R – Relate – and how we can harness the power of connection and relationships to further support the child in reaching or maintaining a calmer state.

Serve and Return

“…being expressive when we speak with, and interact with, our pupils helps them to feel safe with us, because we are not being ambiguous. They know how we are responding to them. They know how we are experiencing them at this very moment” – Dan Hughes

- Notice what the child is noticing. Point to and name what has captured their attention. Look for the initiatives which they are communicating and respond by returning their eye contact, nodding and looking interested. Reflect back and paraphrase what they say, so that you can check your understanding and show that you’ve been actively listening.

- We may inadvertently convey an underlying frustration or exhaustion through our non-verbal communication. Evocative cues, as Dr Bruce Perry explains, can remind the child of a time when they were ignored, rejected or frightened. An ambiguous face may be interpreted as a threat by a child who has experienced trauma and loss. We can be expressive through big smiles, raised eyebrows, an open mouth and a melodic tone of voice.

- Rather than using language which attempts to divert or fix a problem, Dan Hughes talks about matching the child’s affect – we aren’t sharing the emotion, but we can use a gentler and slower voice in response to sadness or an open posture and firmer tone for anger. Matching the rhythm and intensity of the child’s emotional expression – while a difficult balancing act and not appropriate for every child or situation – can help them to “feel felt”.

- Key components of the PACE approach are Acceptance (“You were letting me know that…”; “I know that you’re upset about…”) and Empathy (“This is really tough for you”; “You must find this so unfair”). These are essential for showing that we are not judging the thoughts and feelings underpinning their words and actions. Using such statements shows not only that “we get it”, but also “we can handle it”.

Follow and Lead

“We need to support our pupils to follow so that they can be dependent on us, rely on us and trust us. We need to support our pupils to lead so that they can become increasingly independent in a healthy way” – Louise Bomber

- Art and musical activities provide the opportunity to connect with children without overly obtrusive language or interaction. Match the beat and volume of the sounds they make or the direction of their paintbrush as you create pictures alongside each other. Simply imitating what they do with a toy shows that you are interested in sharing the experience and entering their world.

- We can help the child to practise how to follow and take the lead. One example is for the adult to start drawing a line around a page, while the child uses their pencil to try and stay as close as possible to the adult’s line. The roles can then be reversed. Similarly, you can take turns copying each other’s facial expressions and actions or replicating each other’s Lego constructions. Another classic is to watch someone drawing a squiggle and then add to it and turn it into a picture.

- Games such as patty-cake, ring-a-ring-a-roses and row-row-row-your-boat have a predictable and repetitive rhythm. They can be demonstrated with other staff or peers first, so that the child knows what to expect. These games also allow for limited and consistent touch, thereby allowing a safer degree of physical connection.

- Arranging time for the child to play with an older or younger peer also provides them with the experience of following and leading. A buddy or mentor system can help to model and teach a range of play, language and social skills – this can be particularly helpful during less structured periods of the day where the child who is being supported may become more easily dysregulated.

Connect and Remember

“As a teacher, you will know about the scaffolding of learning tasks, giving pupils enough support to gradually be able to do the task alone. Some pupils also need emotional scaffolding, where the teacher notices what is happening, describes it and helps the child to manage the feeling” – Marie Delaney

- Louise Bomber outlines the concept of “wondering aloud” as a method of communicating our attention and being curious about the child’s inner experience. Just by saying “I wonder if you’re feeling worried about…” or “I’m guessing that you might be frustrated because of…”, we are conveying that we see what is happening on the inside as well as the outside. Naming the feelings out loud is the first step towards taming them.

- When it comes to the curriculum, we need to think about how information can be relationally mediated. A concept, topic or skill may be more meaningful and memorable when it’s related to the child’s personal interests or motivators, a real world example or a context which makes them smile and laugh. Incorporating action and rhythm into new learning is not only regulating, but it can also create a lasting motor memory derived from our interactions.

- We can be explicit about keeping the child in mind. “I remember how you like…” shows that you were listening when they talked about a favourite place, game or TV show. “When I saw that, it made me think of you” helps to convey that you have been thinking about the child even when you weren’t together. As some children can be sensitive to praise, they may enjoy seeing their strengths and positive qualities depicted in drawings, posters, certificates or a scrapbook of photographs.

- Think about tangible ways of emphasising that the relationship continues to exist during separations from school staff or parents/carers. Photo keyrings, a scented tissue or a small toy can be used as transitional objects. Drawing hearts on each other’s wrists can be a visual yet discreet reminder of the enduring bond. We can also remember to come back to something the child enjoys doing or talking about using a post-it-note or memory card.

Reflect and Respect

“…in order to feel emotionally close to another human being, our defensive system must temporarily shut down…the brain needs to turn off its natural vigilance” – Bessel van der Kolk

- Playfulness is crucial for presenting ourselves as safe, approachable and fun. It also helps to balance our use of authority and discipline. Kim Golding describes how PACE is much more about the joy in relationships rather than toys and activities, particularly as it can be easy for a child to become over-excited from a playful approach. We can indulge in small but regular moments where we are relaxed and silly, whilst being mindful of occasions when a child may be less receptive to such cues and prefer time and space on their own.

- Certain aspects of the curriculum can pose challenges, such as learning about the history of people and places, writing about family experiences or discussing their sense of identity and personal values with peers. We can create emotional distance by role-playing or writing from the perspective of a different character. Stories and metaphors can be a safer conduit for engagement. We may also need to give extra time and guidance for the child to develop scripts about Christmas, birthdays and Mother/Father’s Day

- Dr Bruce Perry talks about the intimacy barrier – children who have experienced trauma and loss may find it more stressful to tolerate personal questions about home life and can perceive touch as very intrusive and alarming. They are more likely to encounter these intimate interactions during less formal times such as PE games, having meals in the canteen and being out in the playground. This is when they will need clear and predictable structure and a trusted key adult or peer mentor to get alongside them.

- We need to be mindful of how our proximity and touch can be perceived. Ideally, we let the child come to us and we keep an open, relaxed and slow-moving posture to make ourselves less threatening. If we need to approach, we can give advanced warning and stay parallel. Choice is an important element when considering healthy and appropriate physical contact in daily routines. Some children may prefer a light fist bump or an air-high-five for greetings. Feely bags, puppets and sensory play can also provide controlled tactile experiences.

Nurture and Integrate

“What maltreated and traumatised children most need is a healthy community to buffer the pain, distress and loss caused by their earlier trauma. What works to heal them is anything that increases the number and quality of a child’s relationships” – Dr Bruce Perry

- Having a trusted adult within school can help to provide a secure base through which the child receives emotional validation and containment. This can be a designated member of staff who meets and checks in with the child in the morning, provides reassuring commentaries during tasks and routines, looks out for them in the playground or facilitates calm breaks throughout the day. The four elements of PACE can all be disseminated through this “significant other”.

- Some children may be find it hard to tolerate physical and emotional closeness with adults in school, so it’s important that we maximise their relationships with peers. A learning activity may feel less daunting when working in pairs or a small group. Random acts of kindness and “What I appreciate about you” exercises can create a sense of belonging and identity without an adult putting it into words. Clubs and shared responsibilities with trusted friends help to provide safe contexts for connection and emotional regulation during less structured periods.

- Having a cohesive team is important for ensuring that the supporting adults receive “therapeutic doses” just like the child. This can include teachers, parents/carers, learning support assistants, form tutors, heads of year, SENCOs and social or youth workers. Meetings can allow for venting and debriefing, collaborative reframing and finding solutions. They also ensure that values, language and strategies are consistently applied.

- When embedding and communicating trauma-aware approaches, we should consider the wider range of people who have regular interactions with the child – reception and canteen staff, playground supervisors, caretakers, sports coaches and wraparound care workers. They all have natural opportunities, within everyday contexts, to connect with the child and expand the therapeutic web of relationships.

References & Further Reading

Bomber, L.M. & Hughes, D.A. (2013). Settling to Learn: Setting Troubled Pupils to Learn: Why Relationships Matter in School. London: Worth Publishing Ltd.

Delaney, M. (2017). Attachment for Teachers: The Essential Guide for Trainee Teachers and NQTs. London: Worth Publishing Ltd.

Hiebert, M., Platt, J., Schpok, K. & Whitesel, J. (2017). Doodles, Dances and Ditties: A Somatosensory Handbook. Denver: Mount Saint Vincent Home.

Hughes, D.A. (2009). ‘Principles of attachment and intersubjectivity – still relevant in relating with adolescents’. In Perry, A (Ed). Teenagers and Attachment: Helping Adolescents Engage with Life and Learning. London: Worth Publishing Ltd.

Kennedy, H (2011). ‘What is Video Interaction Guidance (VIG)?’. In Kennedy, H., Landor, M. & Todd, L (Eds). Video Interaction Guidance: A Relationship-Based Intervention to Promote Attunement, Empathy and Wellbeing. London: Jessica Kingsley Publishers.

Meredith, M. (2020, October 3rd). Trauma-Informed Practice. Where do I start?

Perry, B.D. (2020, April 2nd). 4. Regulate, Relate, Reason (Sequence of Engagement): Neurosequential Network Stress & Trauma Series.

Perry, B.D. (2020, April 8th). Connecting under Duress: Neurosequential Network Stress & Trauma Series.

Perry, B.D. (2020, May 20th). 13. The Intimacy Barrier: Neurosequential Network Stress & Trauma Series.

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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