Friday, June 27, 2008

Trouble, part three: time outs and the limbic brain

I’ve been revisiting a book I read years ago before Ben was born. It’s called A General Theory of Love.

Despite the seemingly chick lit title, the book is a scientific exploration of the parts of the brain that are involved in the feelings of connection and relatedness and intimacy with others. It’s beautifully written and fascinating; and if you’re the type of person who likes a few Shakespeare quotes with your science, this book is for you.

The central thesis starts with the idea that human beings’ brains have three parts – a reptilian brain that controls basic functions, a limbic brain that controls emotions and relationships and a neo-cortex that handles reasoning, planning, creativity, algebra, conjugation of verbs, and the like.

Obviously the neo-cortex is what separates us humans from other beings that don’t solve for x, or manage hedge funds, or invent color names like “sage” and “putty.”

But this book focuses on the limbic brain. What separates all mammals (including us) from those creatures who have not evolved with limbic brains is that we are wired to care about each other. A lizard will watch it’s offspring being eaten by a bird and not bat an eye, but a mother tiger will attack – or risk her own life – to protect her cub. This is the work of the limbic brain.

Not only are we wired to care about each other, but we are wired to need each other.

Animals with limbic brains suffer, and even will die, when they lack connection. This has been studied in lab settings with animals, but also seen clearly in the cases of mismanaged orphanages where children tragically languish without love and comfort of adults.

The authors of the book refer to this as phenomenon as limbic regulation.

Closeness – both physical and emotional – with another person actually optimizes our bodies’ systems. We send and receive messages from others around us that affect our limbic brain. These unconscious messages that pass, for example, between mother and newborn ensure that a newborns’ breathing and heart rate remain regular, as well as govern a host of other physical functions.

In short, humans in close relationships regulate each other.

The reason I went back and read the book is because I began seeing references in others’ writings about children on the spectrum referring to a difficult moment or a tantrum as dysregulation.

In the light of this idea of the limbic brain and how relationships help us function, it made perfect sense to speak of tantrums and other difficult moments as dysregulation; or the state of not being regulated.

When Ben was about two and a half or three, we decided to try the normal “time out” strategy. When he was misbehaving – throwing things, hitting us – we’d warn him and then remove him from the situation for a time. (see: 1, 2, 3 Magic.)

For most parents, this means having the kid go sit in a special chair or stand on a special rug in the corner or to their room.

Apparently (and to my amazement) I learned that most children actually stay in these spots during time out.

That’s not the way it worked for us. Leaving Ben in his room alone while he was in this state meant that we risked having him hurt himself or at any rate break stuff – big stuff.

He would not stand or sit in one spot. So a time out meant sitting with one of us with us holding his arms so he could not hit us or himself. Sometimes we would lay him down on the bed and hold him there until he was calm.

While holding him down seemed preferable to allowing him to hurt himself or us, it never seemed like it was helping him to learn how to behave differently the way a typical time out is supposed to. I was never sure if he saw it as a consequence even though he clearly did NOT enjoy time outs: he protested these episodes with kicking and screaming.

The phase of frequent throwing and hitting passed, so we were doing time outs a lot less frequently. But we started to notice that Ben was sometimes saying when he got on edge, “I want a time out.”

Why, I asked myself, does he want a time out? He hates time out.

“You don’t need a time out, Ben. You didn’t do anything wrong.”

“I want a time out.”

“No, we’re not going to have a time out.”

Then he would throw something or knock something off a table.

He started doing this at school, too. Asking his teacher for a time out and then misbehaving flagrantly when he didn’t get one.

His teacher asked one day, “Ben, what happens when you get a time out?

“Daddy holds my arms tight.”

There it was. While he never seemed to like the time outs we did, he was craving something about the feeling he got when we held his arms during a time out.

This is when I first learned about proprioceptive input. Many children on the spectrum respond well, his teacher explained to us, to pressure applied to the joints and muscles. And from then on, we offered him “tight squeezes” and “tight hugs” all the time, especially when he appeared to start getting on edge, anxious. The staff at school did the same thing, and we saw a huge decrease in behavior problems.

While proprioceptive input is generally regarded as treatment for sensory issues, the concept made me recall what I read about limbic regulation. Maybe it wasn't just the pressure itself, but the also something about the feeling of closeness and connection it provides.

We now make a point try to offer a steady, preventative limbic diet of hugs, squeezes, cuddles and close, physical play.

Perhaps we need a new PSA:

This is your limbic brain. This is your limbic brain on hugs.


Jordan Sadler, SLP said...

You've done such a beautiful job of describing this; I will be sending more than one parent this link. Ben is so fortunate that you understand him - and take the time to figure out - his needs so well.

Anonymous said...

Please take all this to a publisher sometime soon, willya?

jaki said...

I think I'd want a time out too...if it meant being held and contact is so important to LIFE!!
Great description, as always and I agree with deirdre...get it published.. all you write is so down-to-earth, easy to understand but full of insight into Ben and many others!
P.S. I could use one of those time outs right NOW!

Anonymous said...

We found the very same thing to be true with Chee. I have even blogged about her frequent and sometimes persistent requests for hugs.

We didn't realize she craved them until she herself started asking for them.

You've done a lovely job of writing this out and explaining it.

The good thing about hugs is they are an anytime, anywhere kind of sensory input. And they are never on short supply.

Anonymous said...

Connor also seeks this physical contact. He will give a tight hug in order to get one in return. Some teachers are thrown off by it- teachers in our society are very concerned about the appearance of a lot of physical contact with students. More people need to know about this!

md'a said...

Are you familiar with the machine Temple Grandin constructed specifically to apply pressure on her upper body? (As a child she had sandwiched herself underneath sofa cushions to alleviate stress.)