In many people, especially young children with developmental quirkiness, a combination of highly reactive amygdala (one of the primary brain centers that responds to threat) and poorly developed cortical inhibitory processes, can generate maladaptive reactions to even minor stressors. The task of the caregiver is to grow the capacity to inhibit these maladaptive stress reactions. 

One way to do this is to make links between the stressor and the perception of threat, building more benign associations than the initial ones. These links include a more realistic assessment of the perceived threat (the shadow, the provocative driver) through the engagement of the more mature inhibitory system that can allow for reflection about the situation. This linking is often accomplished with explanations. For example, “I think that the reason you pinched the other child is that he was sitting in your place.” This simple suggestion can be followed by a reflection on a more adaptive response such as, “Maybe next time you could tell him that was your place and ask him to move.” Such an explanation, in order to be helpful, usually requires the context of a “safe” relationship, one in which trust has been built up over a series of empathic interactions. 

Other ways to build this self-regulatory capacity include occupational therapy (OT) and behavioral therapies. OT is particularly helpful when it involves frequent opportunities to practice activities that support brain growth, either with frequent therapy sessions or – preferably – when the therapist works with the parents and the school to institute therapeutic activities in the child’s home and school. Many activities support the development of self-regulation. They include repetitive, rhythmic, motor activities such as drumming, swinging, walking, (Perry, 2006). I have had good experiences with singing, primarily because of the soothing quality of some music, but also because of the regulating quality of controlled breathing involved in singing. Regarding behavioral therapies, I am biased towards behavioral therapies that emphasize the relationship between the clinician and the child. 

Unfortunately, many parents and teachers grow impatient with the slow pace of these therapeutic interventions or with the intensity that is sometimes required. They can be helped with gentle reminders that these interventions are not designed to “cure” a problem, but rather to “grow” new brain capacities. 

Dealing with Stress Reactions

Perry B (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children, the neurosequential model of therapeutics, reprinted from Working with Traumatized Youth in Child Welfare, edited by Nancy Boyd Webb. 

Porges S (2009). Reciprocal influences between body and brain in the perception and expression of affect, In: The Healing Power of Emotion: Neurobiological Understanding and Therapeutic Perspectives, Eds: D Fosha, D Siegel, M Solomon, WW Norton & Co.

One challenge to parents and teachers dealing with very young children, or children with impulse control problems or temper problems, is stress regulation. We as humans have multiple neural systems to regulate stress. In humans, the perception of threat is registered as stress, on a continuum from mild anxiety to overwhelming trauma. Our life experience and our genetic inheritance influence the meaning we make of sensory input – visual, auditory, touch, postural sensations – creating a repertoire of meaningful associations over time. Potential threat initiates what Bruce Perry calls “a cascade of patterned neuronal activity in these primitive areas of the brain, which moves up to more complex parts of the brain” (Perry, 2006, p. 31-32).

In my clinical experience I see children whose repertoire of meanings include traumatic touch, for example in children who have experienced abuse. I also see children for whom certain kinds of touch is perceived as threatening not because they have been abused, but because their sensory system is over-reactive to certain kinds of sensory information. One reason for this can be developmental problems subsequent to prematurity or genetic vulnerabilities. This sensitivity can also be true of visual and auditory stimuli. For some children, a direct gaze can be overwhelming, because they have been traumatized by violent experience – such as the color red – or because their social engagement system cannot tolerate direct social contact. 

Although current thinking conceptualizes the stress response in a more complex way, the traditional and simpler way of understanding the stress response in terms of the “paired antagonism” of parasympathetic and sympathetic systems of the autonomic nervous system (Porges, 2009, p. 4). According to this model, the sympathetic nervous system governs what is the commonly known as the “fight or flight” response. An initial response to the perception of a threat, registered in the limbic system of the midbrain, especially the amygdala, may cause flight or an aggressive reaction. For example, if an individual sees a threatening shadow in his room, he may lurch backwards, or if he is provoked by a competitive driver, he may gun his engine. Usually, however, an inhibitory response in the cerebral cortex is stimulated to calms the individual in the first instance so that he can inspect the shadow and realize that it is a coat hung on a chair and in the second instance so that he can reason with himself and consider the dire consequences of road rage.

Perry B (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children, the neurosequential model of therapeutics, reprinted from Working with Traumatized Youth in Child Welfare, edited by Nancy Boyd Webb. 

Porges S (2009). Reciprocal influences between body and brain in the perception and expression of affect, In: The Healing Power of Emotion: Neurobiological Understanding and Therapeutic Perspectives, Eds: D Fosha, D Siegel, M Solomon, WW Norton & Co.