Jean & Alex Part 3 of 3: When You Want to Get Unstuck

It's not unusual to feel stuck or trapped as a parent. Having options is the antidote to that feeling. You have options for how you think, how you behave, how you deal with emotions. And those options put you in the drivers seat…you get to see and feel the choices you have and you get to choose! This episode is the third and final episode with Jean and Alex who are dealing with their 6 year old daughter’s big emotions. We focus on how to change your mindset and review several coping strategies to help your child. 

Time Stamps

3: 22 Naming the skill - dialectic dilemmas and dialectic synthesis 

4:20 The dialectic dilemma is between the child’s needs and the parent’s needs.

5:15 Having options is a necessary element in our mental health - Noticing your “choices”

7:10 Helping parents helps our children:  realizing that your mood impacts your child’s mood

11:50 GIve your child (or anyone) permission to actually have the big emotions

13:20 Main dialectic dilemma between Acceptance and Change

• Acceptance often is needed first - it’s more effective to accept the moment before you try to change what’s happening
• First thing to do: Acknowledge the big emotion. 
• Then move onto solving the problem

20:25 A description of three states of mind (illustration of states of mind in show notes)

22: 50 Take your time teaching these skills to your child:  repeat it, use different metaphors, say it differently, use different examples

25:00 Skills to use to move your child from emotion mind to wise mind

• Acknowledge that your child is in emotion mind: Name it
• Rate it
• Distraction
• Flexible thinking - dialectic thinking with the magic AND
• Ice pack across your eyes, or face plant into a bowl of cold water
• Breathing Exercises (see Link to handout below)
• Puzzles, activities

25:44 Explaining how to move from the sympathetic nervous system to the parasympathetic nervous system to help us regulate

31:41 Do you feel different? Is the helpful question

34:32 weave the DBT skills and emotional regulation language into your everyday language.

36:13 Exposure work can be done as gentle exercises to help your child with uncomfortable situations

• Start easy and work you way up to harder situations 
• Mantra:  I’m scared and I can do it anyway
• STAY present
• Have faith that your child can do it

The goal is not to avoid the problem, the goal is to be reduce your emotion and return to the problem

Resources:  

NEABPD free Webinar presented by Leslie Cohen-Rubury titled “Defiance, Disrespect and Disobedience: What it is and What to do about it.” Click here to register

Handout on Mindfulness Breathing Exercises 

Video on three states of mind 

Leslie-ism: When you feel stuck, look for the options (I promise you they are there)

For a full transcript of this episode and more information about the host visit https://lesliecohenrubury.com/podcas

Transcript

[Music: The Wilds Beyond by L-Ray Music]

[00:00:00] Jean: I've also noticed I have a lot of rigid thinking that I didn't realize I had. So even just that, that choice of saying, “Oh, I can choose to withdraw now, or I can choose to engage.” And it's more fun to realize you can choose. You don't have to just react immediately.

[00:00:22] Leslie Cohen-Rubury: Sometimes realizing that you have options is a revelation. It's not unusual to feel stuck or trapped, and realizing you have options is the antidote.I’m Leslie Cohen-Rubury, and this is, Is My Child A Monster?, a parenting skills podcast where you get to listen in as real parents and caregivers share their trials and tribulations in coaching sessions recorded live. And no, your child is not a monster. Just misunderstood. 

This is my third and final session with Alex and Jean, who are raising 6-year-old Ellie and 3-year-old Ezra. As we've talked about in earlier sessions, Ellie has intense emotions and her parents are confused and frustrated in their efforts to help.

Sometimes we keep trying the same things over and over without realizing we're falling into a pattern. That's when we feel stuck; and getting unstuck comes down to realizing you do have options. That's what we talk about in this episode. Jean and Alex have realized they have more control than they thought, and we explore additional skills for emotional regulation. We also talk about practical strategies to help Ellie overcome her phobia of removing bandaids. 

So now as a reminder, all the names and identifying information have been changed, and though I'm a licensed clinical social worker, this show is for informational purposes only and is not a substitute for therapeutic  intervention.

So let's begin.

[00:02:03] Leslie: Hi Jean. Hi Alex. 

[00:02:05] Jean: Hi Leslie. 

[00:02:07] Alex: Hi. Good to see you again. 

[00:02:08] Leslie: Good to see you. So, how are you doing? 

[00:02:12] Alex: I think overall we're doing pretty well. We have some, I think, good follow-up from our previous session and then some things to revisit from the previous session. 

[00:02:23] Leslie: Okay. 

[00:02:23] Alex: So we had been talking about your idea of black and white textures, like a polka dot, versus gray compromise and how if you go for the gray root, nobody's really getting what they need. And I think at least I have benefited, I think, a lot from that. I've been able to sort of take some times to stop what I'm doing and realize I can pick it up again later to give some more focused attention, some more quality time in that moment, and then pick up what I was doing later. 

And it's more enjoyable. I've been enjoying my time with her more. It seems to stem the flow for her need for affirmation to a certain extent. And it made a lot of sense to me and I'm seeing how it works. 

[00:03:16] Leslie: Wow, that's very cool. And I want to hear from you, Jean, in case you have some feedback on that. But it's finding a synthesis to a dialectic dilemma. And I'm going to be picky and repeat that name for you because it really is wonderful to have access to the name. Because if we were looking at a toolbox and I said, “Can you give me that thing, that thing that makes noise,” you don't know if I'm talking about an axe, you don't know if I'm talking about the hammer—you don't know what I'm talking about. 

The name actually just makes it a little more accessible and I want it to be something that you can teach your children, even your children who are very young. We’ve got a 6-year-old and a 3-year-old. So, yeah, we want to teach it to them young. It's called a synthesis to a dialectic dilemma. The dilemma is between, what? 

[00:04:12] Jean: It's between us wanting to do what we want to do in that moment, and Ellie wanting the attention she wants or needs in that moment. 

[00:04:21] Leslie: Great. And there's no one that's wrong for having needs. Except when we don't understand how to find a synthesis, how to understand dialectic dilemmas, we feel like something's wrong. We feel like, “I'm doing something wrong, she's doing something wrong,” and we want get away from that. 

So dialectic thinking—which has dialectic dilemmas and dialectic synthesis, there's a whole lot of nuances in terms of the definition of the word—what we're trying to do is understand and give our child flexible thinking. So that when we're understanding a thought that comes in our mind, we don't get rigid. 

And I love, Alex, that you said you feel happier, I think something like that. It's more pleasant to be interacting with your daughter because there is a flow to it. There's a flexibility to it. There are options. Options are one of the greatest ways to ensure mental health. 

[00:05:21] Alex: And it's almost like just deciding to enjoy that time with her because just deciding, “This is what I'm going to do. I'm not doing this while I'm waiting to do the thing that I'm supposed to be doing. It's like, “No, this is what we're doing now, and then I'll do the other thing then,” and we can actually have that time together. So, yes, it's easier and happier. 

[00:05:43] Leslie: Wonderful. That sounds great. Okay, Jean, do you have any feedback on how that idea impacted you? Did you get to use it? 

[00:05:52] Jean: Yes, I definitely used it. I feel very much the same way that Alex just described. For me, I think, you helped me see, in the previous episode, that I was doing a lot of withdrawing; basically, when she would need me, my first reaction would be frustration: I don't want to connect. I want to be by myself. And for me, that's a pattern that I go into when I'm feeling stressed or anxious. 

So you just helped me notice that, and it made it…actually, I don't know if this is different, I think of the word dialectic when I think of this, because to me it means like two. Because what would happen is Ellie would come up to me wanting something. And I would have that immediate, frustrated feeling, wanting to withdraw, and then I'd sort of put that on one side, and then on the other side I'd see, But this is Ellie, my daughter, wanting to connect. And I actually want to connect with her too. I haven't connected with her all day, and I just sort of choose to go with that version. 

And it's really helped. It's way more fun. And I think, like Alex said, it helps her, it just helps her feel more grounded, so that when she does have these unexpected discomforts, physical or otherwise, she does seem, in general, more able to handle them without going into this huge response.

[00:07:08] Leslie: So, it's so interesting that you come to me to get help for your daughter, and I focus on new ways for you to interact with your daughter. But I put the focus on you. And I just want to hear you say it again that it's actually helping her. Is that true? 

[00:07:28] Jean: It is really helping her and it was astonishing to me that my mood would impact her mood so much. That was a really good lesson to learn right now, as opposed to later. 

[00:07:42] Leslie: Yes. And I really appreciate that you're sharing that because we can admit it, but we don't want to admit it and we don't want it to be true. But it is true. It is true that our children, even the least sensitive ones, no matter who your child is, they pick up on how their parent is doing. It's evolutionary. Their survival depends on your survival. And so when they are tuned in, and those are mirror neurons and here's a physiological reason how they tune in. And that's an attuning process. We want to help them co-regulate by paying attention to our own system.

So you're using dialectic thinking. And yes, what you were doing was, in that moment where you were feeling within yourself, the dialectic dilemma, there's a dialectic dilemma between you and your daughter, Ellie, in those moments. And you identified the dilemma within yourself that, there's part of me that wants to just be by myself and leave, get rid of my kids and be all by myself.

And there's a part of me where I'd love to connect to my daughter. That's also the dilemma. And by naming it, it brings it to the surface. It gives us—I'm going to say the same thing—it gives us the option, Well, what do I want to do now, what do I want to do later, how can I address this? And the synthesis of recognizing that tension, that pull, is a beautiful thing. I'm going to say it again, that when we feel we have options, our mental health improves.

[00:09:23] Jean: I agree. It reminds me of when you describe flexible thinking versus rigid thinking. Because, since our last recording, I've also noticed, I have a lot of rigid thinking that I didn't realize I had. So even just that choice of saying, “Oh, I can choose to withdraw now, or I can choose to engage,” and it's more fun that way.

It's more fun to realize you can choose, you don't have to just react immediately. And of course that's what we're trying to teach her, but we…yeah, we can work on that ourselves. And she loves watching us do stuff like that. I was giving her a bath. I was talking to her about anxiety and worry and how it works, because that's something I'm learning too. And she was transfixed. Her eyes, she's just like, “Tell me, what's that word again? Amygdala—what is that?” She wanted to know everything. So even just writing down, finding synthesis to a dialectic dilemma, she's going to eat that up. She loves that stuff. 

[00:10:14] Leslie: I love it. Yes. And don't be surprised when we teach kids our skills; the big one when they say it back to us is when they say, “Mommy (or Daddy), you're in emotion mind. That's the one that gets us. And it's like, ooh, don't tell me I'm in emotion mind, but it's very true. They are probably using the emotional intelligence, the language, that actually describes what's going on. And we want to give them that language very early on.

[00:10:41] Jean: Mm-hmm. 

[00:10:41] Alex: It's especially true when you don't want to hear it. 

[00:10:44] Leslie: Yes, yes. Sometimes we just don't want to hear it. And at that moment I would take a deep breath, take a pause, and say, “Yes, you are right. I am in emotion mind. Thanks for noticing.” And then you might add, “I notice that I'm feeling very hot. I notice that my face is warm, that my hands are gripped,” or whatever. “I notice that anxiety is talking,” and all of that. 

Naming and noticing is such a wonderful way of regulating some emotion for ourselves, teaching our children what's going on with them, and then giving them a tool, literally called noticing and naming it. That's what we want to teach them. It's less about fixing your children and more about giving them the information they need to help themselves.

And that actually reminds me, one of the things that people don't think about, but I find is very powerful, is if my child is having that tantrum. I actually give people permission to have rigid thinking, have big emotions. Because no one really wants to have rigid thinking and big emotions. So I say, “You have a choice. You can continue with your big emotions. Or if you want a little help regulating your emotions, you can ask for help.” So in that moment, I might even give my child permission to have a big emotion. 

[00:12:16] Jean: Right. And I think that leads to another question that I think Alex brought up with me earlier, which is just…Let's say the unlikely event comes up where Ellie says, “Yes, you know what? I would like help regulating my emotions right now.” I don't think we know how to do that, because historically she has not been open to that. So I just wonder what are some things you can do in the moment of emotional distress that can help a child I read—I do remember one time—and it's something we've tried a few times, actually: you mentioned giving a kid something cold to hold because it kind of helps them focus. It helps them focus back on their body. Or physical sensation can help sort of quiet, some of that other stuff going on. So I do remember that. You've probably mentioned this before, but I just don't remember other strategies we could use. 

[00:13:10] Leslie: Okay. So there's a lot of wonderful, incredible skills. Let's see what pops up in my mind right now. The first one is, since we were talking about dialectic dilemmas in DBT—Dialectic Behavior Therapy—the main dilemma is between acceptance and change. Do I need to accept this moment as it is? and all the strategies that we teach people to accept the moment. There's a lot of strategies for that. Or do I need to change the moment? Do I need to solve a problem? Do I need to change something going on, my behavior, my emotions?

And the answer is not one or the other, because we're talking about dialectics. It's about both. So we need to find the balance between accepting a child's big emotion and teaching your child to change their big emotion. Which one do you think comes first? 

[00:14:09] Alex: Accepting the big emotion. 

[00:14:11] Leslie: That's going to be more effective. Most of the time it's more effective to accept the emotion and then work on changing it 

[00:14:21] Alex: Because you kind of have to work from where you are at the moment. 

[00:14:24] Leslie: Bingo. Exactly. So that's your first goal. And it is not your first instinct as a parent. Your first instinct as a parent is, Let me help you. Let me get you out of this pain. Let me quiet you down. Let me fix this. And so we jump in with fixing. It is like holding back a race horse. You’ve got to hold your horses and you’ve got to say, let's first regulate the emotion mind. So the first thing you can do is say, “Wow, I noticed you're in emotion mind. This is really upsetting,” whatever you want to do to just acknowledge that there's big emotion here.

The first thing is: don't worry about solving the problem of the moment, whether it's taking the Band-Aid off, whether it's getting back on the bicycle. Don't worry about solving the problem, make it clear that you're here to regulate the emotion first. Mm-hmm. So 

[00:15:22] Jean: I have a question. One thing that happened recently is when she would stub her toe or fall down, she would cry and freak out a little bit. You know, it was more than just, “Ow, this hurts.” It was more like, I am going to die. So I would hug her. And what started to happen is she would almost…the hugging almost seemed to reinforce it, like a reward. So then her emotions got bigger and bigger and bigger. And as she started, I would be hugging her and she'd be sort of smacking on me at the same time, because she's so worked up.

So then I stopped doing that. I stopped. I said, “I'll hug you when you are regulated. I'll hug you when you do have a calm body.” And that doesn't feel right either. So my question, I guess is…I don't know what my question is. I don't want to do that again. I don't want to say, “Oh, I'll sit with you until you feel calmer,” and then have that be like a reward so that the emotion mind gets, encouragement to last longer and longer and longer.

[00:16:30] Leslie: Good question. Alex, you want to jump in with your question or do you want to hold it for a second? 

[00:16:37] Alex: I'll mention it and we can bookmark it. It's almost the opposite of that actually, where, if I do try to sort of have her gauge what's going on or ask her if she's upset; the attention on that almost infuriates her a little bit and she doesn't…Like, she'll pull away from that sometimes if I'm trying to just find out what's going on emotionally for her. 

[00:17:08] Leslie: Okay. So, I'm going to combine those two questions and bring it back to: what do we want to be focusing on? Jean, you’re focusing on: What do I do right? Do I hug her? Do I not hug her? Do I tell her to do this? A minute ago, before you gave me these examples, what did I suggest is the first step? 

[00:17:32] Jean: The first step is accepting the big emotions. Which, in my mind, how do you show you're accepting? Do you ignore it? What does that mean, to accept? 

[00:17:45] Leslie: Okay. The beginning is to notice. Acceptance is acknowledging the pain that is there. And Alex, you said, “Begin where she is,” so let's acknowledge where she is. “Oh, I notice you're crying. I notice you're upset.” And notice that I'm saying it calmly. I don't want to get excited. I might not even make a big deal out of it because I want to be a little bit more neutral.

I don't want to be overly effusive, I don't want to be dismissive, I just want to be neutral. I think with her, we need to be a little neutral. And my guess, just in the three sessions that I've had with you guys, I see how attentive you are. You are attentive to details. You're attentive to making sure everything's going well. I mean, you are really attentive, thoughtful people. If you are that attentive and that thoughtful to your child's emotions, every one of her emotions is getting attention. 

[00:18:45] Jean: Yes, that's hard for us. I think some we're not consistent, so sometimes we take the approach of completely ignoring, just not responding at all. Sometimes we'll do what you say. We'll say, “Wow, I noticed you're crying. I noticed you stubbed your toe. It looks like you're in pain.” And then we'll kind of walk away, because then what do you do? You just stand there for five minutes? That's kind of awkward too.

I mean, sure, we have discomfort when she is uncomfortable herself. But I think it's hard to know how to balance. On the one hand, she wants that attention, she wants us to notice that she's hurt. And on the other hand, it's really not a big deal. So…

[00:19:32] Leslie: …according to you.

[00:19:33] Jean: According to us, yes.

[Laughter] 

[00:19:35] Leslie: Okay. So let's go back to: she's stubbed her toe, she's crying. Having the idea of trying to stay in neutral might be a simple guideline that might help you. But the important thing is to know what you're trying to accomplish. 

And I would—not every time 'cause it'll drive her nuts—I would name that she's an emotion mind. “You are in emotion mind. That's okay. It's okay to be in emotion mind. I want to neutralize that as well. I also don't want it to come across as judgmental, like, “You're in emotion mind. You’ve got to get out of it and then I'll give you a hug.” I don't want that to be good or bad. I want it to be, it is what it is. “You're in emotion mind.” Sometimes I would leave it at that.

And when she's not in emotion mind is when we need to talk about, here are some skills to use when you are in emotion mind. So I would draw the picture of either a continuum—we're on one end, it's emotion mind; the other end, it's reasonable mind.

And the overlap of the two is called wise mind. And I would say when we're in wise mind is when we do a good job of solving our problems and living the life we want. That's where we move forward in our life. That's where things happen. So I would say once in a while we go visit emotion mind.

But if we want to solve a problem, we want to get ourselves to wise mind. “Sometimes you just want to cry in your room and you want to stay in emotion mind, and there's nothing wrong with that. Sometimes you want to lie in my arms and tell me about a worry, tell me about a fear, tell me about where you're angry. And we just sort of stay in emotion mind sometimes—that's okay. But there are other times where it's not working for you and we want to get to wise mind. Can you think of a time when you're in emotion mind, when you wanna get to wise mind?” “Well, if I hurt myself at school and I want to go back to the playground. Or I fall off the bicycle and I want to keep riding with you, Daddy. Or we're at the doctor's office and I'm in emotion mined” And just sort of help her name. It makes sense. It will be effective for her if she can move herself from emotion mind to wise mind. 

Now, I'm teaching this to you in five minutes. I want you to take 15 years to teach this to her—this is not a one and done lesson. Take your time, repeat it, say it differently in different ways. Come up with different metaphors. Come up with different examples. Don't think you have to do everything before she turns seven. 

[00:22:16] Alex: I think knowing that will also be helpful for our own sanity and anxiety, because then we're not thinking, Oh, there's, there's got to be a way to get her to understand this now. I mean, she's just not doing it. It's okay that it takes a long time. 

[00:22:33] Leslie: And I must add the caveat before you go on. If she rejects it, like my daughter did, do not take the bait. She's hearing every word you say and it's going in. My daughter kept telling me, these skills are stupid. This doesn't work. I didn't believe a word and I kept doing my work. It's a slow process of raising a child.

[Music: In the forest by Music for Videos]

[00:23:20] Leslie Cohen-Rubury: Hey everyone. I have a special announcement. I'm giving a free webinar that I'm super excited about. It's called “Defiance, Disrespect and Disobedience. What is it and What to Do about it?” It's hosted by the National Educational Alliance for Borderline Personality Disorder, and it's open for everyone. The webinar is on April 24th at 7:30 PM Eastern Time. And it's free, but you do need to register for access. You can find a link to do that in the show notes or at ismychildmonster.com. I really hope to see you there.

[00:23:20] Leslie: Did you have a question, Alex? 

[00:24:06] Alex: Yes. I was just wondering if there might be anything to glean from these funny little moments that always happen, that I've observed for a while, where she…something happens and she gets physically hurt in some way, and it may or may not be really bad, but her emotional and physical reaction to it is really extreme. She's practically choking on herself, screaming and sobbing. 

And then she'll notice something. All of a sudden she'll need to correct us about something that we said. She'll, she'll stop, she'll be breathing normally so she can say the thing. Or she can, you know, say something to her sister. And once she's sort of gotten through that, then she'll turn it right back on again. And she seems just as upset as before. And I don't know if there're any clues in there that are helpful for her…if it's just distraction, if she's sort of stopped noticing her anxiety for a minute and then remembered or…

[00:25:12] Leslie: So, I do not look at that as, “Whoa, you are manipulating me because you can be fine one minute and then you're not fine the next minute.” I look at that as that's how the brain works. I can flip from the back of my brain—the amygdala that you were talking about in emotion mind—and I can flip to my wise mind, which is the prefrontal cortex or the thinking part of my brain, in a breath. In one breath. 

[00:25:42] Alex: Exactly. And that's what I'm wondering. Is there a way we can help her tap into that, sometimes? 

[00:25:46] Leslie: So, you named distraction, when someone is emotionally dysregulated. Let's make a list right now of some strategies for her to use to get from emotion mind to wise mind. And I want it to be a list that's alive. Alive, meaning it changes and you put things on and you take things off and you add to it, so that she sees that there's always things that might change around some distracting techniques. So, you mentioned, Jean, the ice or the cold pack on the eyes, or with adults, we tend to use a cold water bath where they put their face—their whole face—holding their breath in cold water. It's remarkable. But what we are teaching is that when we have hyper-arousal in our body—we're all excited, we're in emotion mind—that is when the sympathetic nervous system is kicked on. 

So, a small way of kicking on your sympathetic nervous system is just inhaling. That wakes up my nervous system. And exhaling, and slowing down and resting our nervous system is our parasympathetic nervous system. And believe it or not, the exhale does that for us. A nice slow exhale. I would say one of the things I'd want to teach her are some breathing exercises. The one I tend to teach children—there are a few of these and she can have fun with you, finding, making them up—is taking your finger, like your index finger, hold it up and pretend it’s a flower and say, “Smell the flower.” There's your inhale. And then the exhale is a candle I'm blowing out, but I moved my fingers so I can blow out for a long time. That's it, Jean. You're doing it. And move my hand further away.

And in the beginning she might not have a long exhale, but the longer the exhale…we want to make the exhale twice as long as the inhale if possible. That will kick on the parasympathetic nervous system so that she calms down. It's really simple. It's physiologically proven to work, and it takes time to get good at it.

So if she's using it, “Hey sweetie, let's use it.” “But it didn't work.” “That's okay. That's okay. The more you use it, the better you get at it. That's what you did with your bicycle. That's what you do with roller skates. That's what you did…” The more we use something, the better it works for us.

So that's one breathing. Another breathing is taking your hand and making it look like a starfish and inhaling on the way up and exhaling on the way down. When you trace your finger, trace it up, inhale, trace it down, exhaling. You can slow it down. If you slow the exhale down, then you're making it paced breathing. But if not, it's just regulating her breathing, which again is very good. 

You can also do where you count your breaths. One—inhale. Two—exhale. One—inhale. Two—exhale. And you can count for her while she's doing it, or you can say, “Count it in your head while you breathe.” So you can do that with her.

And you practice these skills at the dinner table, in the car, not when she's dysregulated, because how well are you going to play your Beethoven's Fifth Symphony for the first time on stage? Or do you practice it in your studio over and over and over and over and over again before you finally get to the stage?

[00:29:15] Jean: I was going to say, for me, it would sound the same no matter when I played it, but I see what you're getting at. [Laughter] And I think she does some breathing exercises at kindergarten that she loves coming home and telling us about, showing them off. So I think she'll like these. And I can't picture, I can't imagine, her doing any of these in the moment in front of us, but I can imagine she'll run away a lot into her room. I can imagine her going in there and doing some on her own and then coming back. I can imagine, when it's not so bad that she needs us or feels that she needs us—she's in a safe space, she's got her own, no one's watching her—I can imagine her even doing that, even while she's young. 

[00:29:57] Leslie: Absolutely. And I would recommend one or both ideas here. One is, if she's reading fine, you can write the skill down. If it's not, make pictures of the breathing, the numbers, the flower, and the candle—all those things. Make a list for her and put it up on her wall or take a bunch of index cards that you cut up and put it in the middle of the kitchen table where it's like, oh, she's upset. “You're in emotion mind. Do you want to go over your strategies? Do you want to go to your toolbox? 

[00:30:29] Jean: Yes, she would love that. We were baking together and she was getting really stressed out and she would not talk to me about it. But I wrote her—she can read, I don't know how—but I wrote her a little survey, like, yes/no questions about how she was feeling; and also whether I was her favorite mommy. And she answered them. She just went over to the table and started answering them. And it snapped her out of it immediately, because she wanted to go take this paper and work on it. So I think she would like a physical reference for these things.

[00:30:59] Leslie: That's fantastic. And that reminds me: when you are in emotion mind, you can use distraction. You don't have to get to the problem, as I've said before. You can say, “Here's a math sheet. Here are some fun math exercises.” Or, “Here are your magnet tiles. Go play with your magnet tiles.” You can use real distraction so that you can say, “Let's first regulate your emotion mind.” And then either move on and be done with it, or go back to what was the problem. Most of the time, you don't even have to go back to it. You don't have to work it out. It's just, “Okay, I got emotional, I regulated. Now let's move on.” So that's a little bit of it all. 

[00:31:43] Alex: And I bet she would really be more interested in trying any of these techniques if she saw us practicing them regularly ourselves. 

[00:31:52] Leslie: Exactly. 

[00:31:53] Alex: They always go off and play whatever the grown-ups were doing. 

[00:31:57] Leslie: Yes. Regulating the body with cold—cold ice pack over the eyes, holding an ice cube, just putting our hands in cold water, stepping outside, changing the physical temperature of your body—will change your state of mind. Intense exercise. “I'm going to race you around the house. Let's go (if outside) up and down the stairs. Let's go up and down the stairs five times.” And then it's, “Do you feel different?” Not let's-go-solve-the-problem. “Do you feel different right now?” 

So, one is changing her body chemistry, her body makeup. We're trying to move from a sympathetic to a parasympathetic nervous system. You can use rating scales, you can use those physical faces that doctors often use for pain scale.

Those are other things. And then we can get into flexible thinking. But most of the time when she's dysregulated, we are going to use whatever distraction to help her calm her body down and then decide, “Hey, should we move on? Or should we go back and talk about that problem?” Sometimes giving her the choice.

[00:33:12] Jean: That makes so much sense, and I think this will be really great for us to do. It's important to focus on just accepting that these emotions are normal, they're okay. You can kind of choose how to respond to them, especially because her younger sibling doesn't really have these big emotions. Just very sort of even-tempered, very easy to distract and sort of move through things. So I do sometimes wonder. Sometimes Ellie asks, “Why doesn't Ezra ever cry like this? Why isn't Ezra upset?” It's like, “Your brains are different. Your bodies are different. And it's okay.”

So I think she'll really like these. Even if we stay in acceptance phase for years, that's still really helpful. 

[00:33:54] Leslie: Absolutely. And ask her if she has any ideas. Is it getting a book out? Is it getting a puzzle out? Is it putting on some music to dance to? And remember, the goal is not to forget about the problem. The goal is to regulate her emotion. That's all. And you can point that out, after the fact. “Hey, if your emotion was at a nine before, now that you finished that puzzle, where are you at now?” Now, I do understand, and you said this before, she could go right back to that nine. That's okay.

And you can say, “Is it working for you?” very gently. Another neutral statement is, “Is it working for you to go back up to a nine?” I'd be curious what she says and if she needs a little more time being emotional—okay.

There's the dialectic dilemma. “It's working for you to go back to a nine. It's not working for me right now, so I'm going to work on my emotion mind.

And I'm going to go work on…” and tell her what you're going to go do. I'm going to do my paced breathing. I'm going to go make my shopping list and I'll be back. I'm right here. We can sit together. You can be in your emotion mind. I'm going to work on getting into my wise mind.” And that kind of thing. 

Again, you don't want to overuse this language. Really be more at ease with it and just weave it into your everyday language. 

[00:35:23] Jean: Mm-hmm. 

[00:35:25] Alex: And I just want to make sure that I understand. With all of this, we're really talking about dealing with something that is happening or has happened, as opposed to anticipating an uncomfortable situation. Because we don't want to get into this situation, like at the doctor, where we're sort of riding the anxiety up and down by delaying and delaying and delaying. Some of the same techniques might help in that situation. But we don't want to… 

[00:35:54] Leslie: There are many, many different kinds of situations. There's no one answer. So yes, these are giving her strategies as to what to do beforehand. The doctor's situation—I want to come back to that for a minute. From our first session, we see that we need to help her with the dialectic statement. I'm scared and I'm doing it anyway. And that is what I'd be teaching there, rather than emotional regulation. “I'm not asking you to regulate, I'm just saying you are going to be scared and we're going to do it anyway.”

And so that's thinking dialectically, that's helping her hold those two opposites at the same time. And that would be my goal in that kind of situation. There are many others. For some other children it might be putting on headphones and listening to a story, a book on tape, while you get a shot. That's a distraction technique. So again, it's what's going work? and what seems to work for her is to move quickly through those situations. 

Now, I had been thinking about our first session and the Band-Aid, getting the Band-Aid off, and I don't think I mentioned this, so very quickly: Did I mention the idea of doing exposures with her when she doesn't have a shot or a cut? And you put Band-Aids on, you take them off, you put them on, you take them off.

[00:37:10] Jean: That sounds so unpleasant.

[00:37:12] Alex: Yeah.

[00:37:13] Leslie: Yes. That's called exposure, and she actually might not care about it when there's no blood or there's no shot. So, in exposure work, because she has this little bit of a phobia about the Band-Aids, I would start on easy things. Maybe she puts Band-Aids on her stuffed animals or her doll, or you; over and over again. And then she pulls them off of you.

[00:37:40] Jean: Okay, so question. We do play that game, and what I do when she pulls it off of me is I start screaming and it makes her laugh. Now when we're playing the game for the goal of exposure, what do I do? [Laughter] 

[00:37:55] Alex: Neutral. 

[00:37:56] Leslie: Yeah. I would be very real. I would say, “Okay, I felt that, the scale of 1 to 10, in terms of pain…If I fell and broke my leg, I think I'd feel a pain about 10. This pain of you pulling off that Band-Aid—I'd say it was about a one and a half.” And so you just teach her. Now, I don't want to make her feel badly, because we all feel pain differently. And we know she's highly sensitive and it's real for her.

So after she pulls Band-Aids off of you, “Okay, let's pull it off of you. Now, there are some places on your body where you will hardly feel it. Let's put a Band-Aid on your your heel. I don't know, I'd figure out where's the least sensitive place on my body and let her do that.

“Say, you know what? I don't even feel it when you pull it off my heel.” And I would just say, every Friday we're going to do a little exposure.”

[00:38:52] Jean: I have another question. I'm under the impression that things like exposure work best when the person being exposed actually wants to change something. And I don't know if she sees this as a problem that she wants to change. So I don't know. First of all, is that assumption true? 

[00:39:15] Leslie: I don't know too many people who feel great about being out of control. And we make that assumption when they're not changing their behavior. It's like, “Well, if you wanted it, you would change your behavior.” And that's a terribly sad judgment, because that's not true. I have spoken to so many young people, teenagers, younger children, and say, “Wow, when you are out of control, my guess is that's not exactly what you want to be doing. You might feel badly about that after. And yet you don't know what to do about it, in the moment.”

And most kids don't want to be out of control. They feel badly about it later. So I'm going to make the assumption she does want it. And I might explore that. I like the idea that we're doing exposures to the things she wants in life. And you can just say, “Do you want to, one day, be able to take a Band-Aid on and off and it be real easy?

And she goes, “Yeah, maybe I do want to do it.” “Okay, well you can't do it yet, but there are some things we can wait and wait till you're 20 and then it probably will be very easy for you to take Band-Aids off.” And why? Because she's taken off enough in her 20 years that she's actually done the exact work exposure.

And you can literally wait because it will get better with time. Or you can do the slow exposure with her where you gently expose her to things that make her uncomfortable, because we do want her to learn the lesson, I'm scared and I can do it anyway. So I'm not telling you need to, I'm saying this is an option. Option for her. An option for you. And slowly increase the difficulty of it. And the great thing about building mastery is to be able to have a sense of accomplishment where you get done with something and say, “I did it.” So you can use that as well when you do exposure. So when she's done with the exposure, say, “What are those three magic words?” I did it. And when she takes it off, she gets to say, “I did it.” And there's that sense of accomplishment that feels good for everyone. 

[00:41:28] Jean: Yes. And honestly, even if we only did the part where she takes a Band-Aid off of us—she doesn't even want to do that anymore. She doesn't really—it scares her. She can sort of feel it on herself, even if it's not her. So I think, yeah, we'll think about trying that. 

[00:41:45] Leslie: Right. And even exposing her to going into the store and buying two boxes of Band-Aids. Everything might be an exposure when someone really is uncomfortable with it, because she doesn't think about just going to the store and buying Band-Aids. She thinks about what it means: If I buy Band-Aids, that means they're going to go on me, and then they're going to come off me. And that's all she's thinking about. So again, it's teaching her to stay present, which is a wonderful skill. Stay present with what's going on here. 

[00:42:15] Jean: I don't know, Leslie. I think she started off hearing about this experience, really liking you. But I think if we tell her about this idea, she is not going to like you anymore.

[Laughter]

[00:42:27] Leslie: I totally get that. She may not like me. And… 

[00:42:32] Alex: She'll thank you later. 

[00:42:33] Leslie: …she'll thank me later. And I don't need the thanks. It's the idea that I totally get why it's scary. “I totally get that this is hard. And—there's the dialectic—I think it would make you feel better if it didn't upset you so much.”

[00:42:48] Jean: Mm-hmm. 

[00:42:48] Leslie: “This is so uncomfortable, and I have faith that you can do it. You don't have faith right now that you can do it. I have faith. You can be scared and do it anyway.” So the idea of staying present, “We are walking into the drugstore. You tell me everything we're doing as we walk in.” “Oh, I see the candy aisle. I see the toothbrush aisle.” And have her describe it. Staying in the moment. I use that skill with every human being of any age. It regulates their emotion, describe one thing in the moment. 

When I have a client that calls me, very dysregulated—let's say a teenager who left class and they are hysterical, crying—I never find out what the problem is. I say, “Okay, you're in emotion mind. My job is to help you regulate and then send you back to class. Tell me one thing in the moment you are seeing.” “Well, I'm seeing these curtains, I'm seeing the…” “Okay, tell me what color are the curtains? How long are the curtains?” And I get someone to use the front of their brain. I calm the person down and I say, “Okay, are you feeling different?” “Yes.” “Okay. Time to go back to class. I can't wait to hear what the problem was, when you come to therapy.” I do want to hear the problem; half the time they forget what the problem was again, even for adults. So does that give you a picture of what you are working on?

[00:44:13] Jean: Yes. I think that paints a great picture. And I think it'll be even more effective if we also work on these same things regarding ourselves, because it's not really fair to ask a kid to do something they think is scary if you're not also doing something you think is scary.

[00:44:30] Alex: And it also just becomes a thing that we're all doing. And so she takes part in things that we're all doing. 

[00:44:35] Leslie: Right. So, last session, when we were making our appointment for today, you were worried that you were going to be late. That was your exposure. Did you practice your exposure? 

[00:44:49] Jean: Yes, I did practice.

[00:44:51] Leslie: …and face it? What did you do? 

[00:44:54] Jean: Leslie…I purchased a countdown timer with a rainbow, so you can turn it to 25 minutes and the rainbow goes down. And what I do now, when I get the kids ready for school, I say, “Here's the time I would like to leave by. This is how big the rainbow is. Go get ready.” And I let them mess around and screw around until they're done.

And honestly, we haven't been late yet, but I'm working on being okay with being late. And it's all thanks to you. 

[00:45:26] Alex: I was late. I used the rainbow and we were late. And it was, and it was okay. 

[Laughter]

[00:45:32] Leslie: Okay. 

[00:45:33] Alex: I was uncomfortable and I recognized it was okay. 

[00:45:36] Leslie: Oh my goodness. So you two are practicing these skills. That is fabulous. You are doing such a beautiful job of soaking in some of these suggestions. Keep going. Just take it slowly. Keep practicing, keep experimenting and don't try to get it perfect. 

[00:45:55] Jean: You've really helped us make a lot of changes already and I'm really excited about moving forward with all these tools you've given us. Thank you very much. 

[00:46:04] Alex: I agree. Thank you very much. 

[00:46:05] Leslie: Thank you. It means a lot to me.

[Music: The Beat of Nature by Olexy]

[00:46:13] Leslie Cohen-Rubury: It makes me smile a little bit when parents say, “My child's not going to like you.” And as a therapist I say, it's really okay if your child doesn't like me. But I get it—when you are a parent and your child says, “Mom, I don't like you. Dad. I don't like you,” it's really important for us to remember that we need to go below the surface.

I talk about this a lot. What is another interpretation when your child says, “I don't like you.” If you make that interpretation of my child doesn't like me, you are doing something called personalization. And that's one of our problematic thinking patterns, when you personalize your child's words. So really try to find another interpretation.

And this goes back to what I spoke about throughout the session, is finding options. Looking for another interpretation is giving you the option. Okay, my child doesn't like me, in this moment. My child actually is really angry that I just said no to them. So looking for another interpretation just gives you some options and that feeling that you're not stuck.

So I want to thank Jean and Alex, who did just that: 

[00:47:28] Alex: We've internalized some of what we learned and put it into practice here and there. Jean and I have both been pausing more to give her attention, even when we're busy and that's been helping. Just a few weeks ago, Ellie had to get a brief, somewhat painful, and scary surprise medical procedure. And Jean was with her and told her that, “This will be hard and uncomfortable and it's okay to be scared and I'm here to help you get this done quickly so that you don't have to feel scared for long.”

And Ellie cried and kind of screamed a bit. And also sat still for the whole procedure while it took place and seemed proud of herself afterwards. 

[00:48:15] Leslie Cohen-Rubury: By changing their perspective, changing their interpretation, and changing their behaviors, they gave themselves more options. So this week when you feel stuck, look for the options. I promise you they are there.

[Music: The Wilds Beyond by L-Ray Music]

Join us next week for an episode about how play can give you insight into what's going on with your child,with play therapist Jen Sims.

Subscribe to Is My Child a Monster? wherever you get your podcasts. And if you feel so inclined, please rate and review wherever you listen. You can find a full transcript of the episode, or sign up for my newsletter, at ismychildamonster.com. 

The Is My Child A Monster? team is Alletta Cooper, Camilla Salazar, and me. Special thanks to Eric Rubury. Our theme music is by L-Ray Music. I'm Leslie Cohen-Rubury. Thanks for joining me.

Transcribed by Eric Rubury