Six-year-old “Yvonne” was an only child and the apple of her parents’ eyes. After she was diagnosed with developmental differences, they enrolled her in a preschool class that included typical children as well as those with special needs. She did so well that the following year she moved to a mainstream kindergarten class.
Just a few weeks in, the teacher phoned Yvonne’s parents to report a problem. Yvonne was humming and tapping on her desk, to the point of disturbing her classmates. The instructor had repeatedly asked Yvonne to stop, even writing the girl’s name on the board to call attention to the behavior. But nothing worked to stop Yvonne from spontaneously humming or tapping at various times throughout the day.
Fortunately for children like Yvonne, neuroscience is shedding new light on how we view emotional, developmental, and behavioral challenges like hers. Disorder-based treatment systems are slowly giving way to methods that are informed by neuroscientific knowledge about human development and that make safety and security their foundation.
Evidence: as of 2015, the National Institute of Mental Health is no longer funding research based solely on the Diagnostic and Statistical Manual (DSM V), the “bible” of diagnoses. Instead, it is directing research money to studies looking at underlying common pathways across disorders and conditions. In other words, the NIMH is encouraging researchers to expand beyond simple labels to identify characteristics that underlie a range of difficulties in emotional and social functioning—such as modulation of arousal levels (i.e. the ability to stay calm).
I have found that understanding these observable characteristics is a far more efficient and effective way to help children and families than the using DSM V or any other checklist-driven labeling system.
This approach is also supported by the work of Dr. Stephen Porges, a neuroscientist and researcher, who has been studying the neural regulation of emotions — specifically the heart-brain connection — for forty years. Dr. Porges says challenges to physiological state regulation underlie many of the conditions childhood mental health professionals treat. He has a term for the brain’s constant subconscious surveillance of safety or threat: neuroception. In short, our brains are constantly (and without our awareness) scanning to determine if we are safe or not.
When a person doesn’t feel safe, everything else becomes secondary. Sadly, many of our treatment methods and techniques overlook this truth. We try to teach or treat children without an appreciation of whether they feel safe, both physiologically and emotionally. And too often we mistakenly blame a child’s difficulties on defiance instead of understanding that the child may be subconsciously detecting a threat in the physical or relational environment. Understanding this offers a new way of supporting everything from anxiety to oppositional defiance to autism.
It certainly helped Yvonne’s parents to put their daughter’s behavior in context. Instead of attributing her behaviors to defiance, they started viewing them as her body’s way of counteracting the subconscious feelings of threat that she experienced in the classroom environment. Not only did she have difficulty processing the sounds in her noisy classroom, she also didn’t have a trusted adult nearby to help her manage her distress. She simply didn’t feel safety in the environment. Her behaviors weren’t symptoms of a “disorder”, per se, but reflections of that lack of safety. Yvonne’s seemingly inappropriate humming and tapping were her body’s adaptive defensive strategy, her way of countering the sense of threat she felt in a new classroom full of unfamiliar people, sights, and sounds.
Yvonne’s behaviors, ironically, were her way to regulate her emotions so she could stay in the classroom. Understanding this enabled her parents and teacher to offer her appropriate support. They made changes to her environment and provided her with noise-canceling headphones, as well as a classroom aide with a sensitive and caring nature.
Those supports changed everything for her. Within a month, Yvonne’s “problem” behaviors decreased, much to the relief of her parents, teacher, and school.
Professionals and policymakers need to update practices to reflect the rich body of neuroscience, including the groundbreaking work of Dr. Porges, that takes mental health support in a whole new compassionate direction, with the potential to change lives for the better.
I introduce simple principles for understanding the critical role of neuroception and relational safety in this book.