Sunday, February 13, 2011

These Kids Will Act Better When They Feel Better

In May I wrote about what it would mean if we really believed that children will act better when they feel better, and discussed what "feel better" would really mean. Feeling better includes:

• Feeling safer

• Felling calmer

• Feeling more connected:

• Feeling better physically

• Feeling less shame

• Feeling more competent

• Feeling more effective

I am struck with the connection between this way of thinking and our understanding about how the brain changes. The brain changes in a use dependent way: what happens often is strengthened; what is not used withers away. What happens together is associated, which means that one thing evokes the other. Many repetitions are needed to change something previously learned or associated. We also know that human interaction is intrinsically rewarding, and that if humans do not have enough of this reward they are more vulnerable to seeking other rewards such as those available from cutting, drugs, aggression, etc.

We want our children to associate human contact with pleasure and help. We want them to experience that life can be a fun, positive rewarding experience. We want them to know that when difficult things happen, you can turn to others for help and use your own skills to surmount them.

It is true, then, that our main function in treatment should be to help each kid have a great day. (Idea courtesy of Martha Holden, CARE project, Cornell). Because having a great day will establish new patterns and templates in their brains. Having fun with staff, repeated many many times, will begin to change their expectations of interactions with others.

I was talking this over with a friend, and he asked: does this mean we should just let the kids do whatever they want, and sit around and eat candy all day? No, it does not. For one thing, feeling better is a complicated phenomenon, and includes all the aspects above- so it demands many activities and challenges. Felling better necessitates lots of the delicious rewards available through social connectedness. For another thing, we have to consider the group. Each person has to have a great day in a way that does not impede the other people having a great day. And thirdly, there is the staff. In order for the child’s template of relationships to change, there must be a genuine, positive engagement with adults. To do this, staff must be feeling hopeful and caring. So promoting anything that hurts or pushes away the staff does not achieve our brain-changing goal.

Therefore, we should be discussing how to create a milieu containing the most possible highly engaged, physical, rhythmic fun for the staff and the kids. Now that would be an interesting treatment team meeting!

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