Regulate, Relate and Reason

I just got done rereading Dr Perry’s thoughts on working with traumatized children using the “regulate, relate, and reason” sequence from his Neurosequential model of therapeutics and I thought it would be good to review this month.

Step 1: Regulate.

Since it is basically impossible to do any work with traumatized children when they are not in the reasoning part of their brain the first order of business is to engage them where they’re at, and that usually means we start by working with them and their brain stems.

Not sure where to start? Try one of these types of regulation:

  1. Somatosensory – heavy work for the big muscle groups, rhythmic and repetitive activities (playing catch, rocking, drumming)
  2. Top down – reassurance. “You’re not in trouble,” “I’m not mad,” “this doesn’t seem like a big deal,” “you’re okay,” etc.
  3. Relational – reflective listening, clarifying questions, practicing empathy (which means trying to understand what’s going on.

There are all sorts of ways to regulate children, and your use of each strategy will vary. Something might work well one day and not the next.

Step 2: Relate.

After we find our way out of  the brain stem, we can get to work on the limbic system. This is where we focus on our love for the child, where we remind them of our love (over and over again). It’s where we reorient our interests with their interests so that they can feel we’re once again working toward the same goals. Focusing on our love doesn’t just mean saying “I love you,” some children love watching youtube videos together or playing janga. Maybe your child likes playing tag, whatever it is, do that!

Step 3: Reason.

Some parents think this is the step to start with, but if your child is not regulated and relational, reasoning is almost impossible. If you get to this step you are doing great. Now that we have some regulation and done the work to make sure they know we are working together, we arrive back to the pre-frontal cortex where we actually have a possibility of solving whatever the problem is.

Only when a child is regulated and relational can they think about what they did, attempt to understand why they did it, repair the mistakes, and reflect on how to avoid these situations in the future. In the reason state, the child can think and talk about what happened, noticing how emotions, sensations, or the environment may have played a role in their behavior. It takes a lot of time to build a strong, healthy relationship and a great deal of commitment to finding the most effective regulation techniques for any child, but their healing, growth, and tenacity are always our goal.

If you would like to read more about Dr. Perry’s model please click on the link.

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