Moving fear into USEFUL anxiety. PACER 12 August 2017 Anne R. Gearity, PhD

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1 Moving fear into USEFUL anxiety PACER 12 August 2017 Anne R. Gearity, PhD

2 Today Examine the connection between fear debilitating anxiety and anxiety that can be useful. Examine ways to restore useful anxiety by focusing on mastery. Provide guidance about how we can best support children and adolescents who struggle to manage and learn.

3 Subjective feelings of fear = state of mind occurring when the source of harm, What is fear? Le Doux and Pine 2016 the threat, is either immediate or imminent. Brain defensive circuit cause defensive behaviors. Resulting changes in physiology = defensive physiological adjustments.

4 And Anxiety = feelings that occur when source of harm is uncertain or is distal in space and time. Le Doux and Pine 2016

5 Anxiety activates stress Stress is not the enemy/ everyday anxieties. Tolerable (useful) stress and anxiety = enough to engage brain functions/ with enough resources/ and adequate adult

6 Toxic stress Toxic stress and toxic anxiety is endangering: too much for too long with too little help. Why help? Remember defensive behaviors and defensive physiological adjustments? These solutions take over without active adult mediation. Toxic stress often defeats learning and mastery.

7 Anxiety is different from worry: Worrying permits Anxiety can become habitual and chronic. specific focus, problem solving and even distraction (I'll think about that later). Anxiety tends to be more diffuse, preoccupying and hard to Often people describe being both anxious and depressed: lack of effectiveness can easily lead to depression. escape because it is more in my body than just my thoughts.

8 Fear brain/ learning brain

9 Sources of fear and anxiety Outside: events or experiences that are or perceived to be endangering. Between: children seek proximity (attachment) to manage fear. When important relationships are threatened or loss is possible, fear dominates. Inside: memories, perceptions, physical distress, dysregulation can cause a child to experience fear from within.

10 Sources of fear and anxiety outside danger inside distress between: threat if real or potential loss panic: I can't

11 I can t do it Childhood is dominated by experiences of I can do it. Connection and exploration lead to mastery. When managing seems too hard, or beyond possible, children and teens often panic, and react with cascading anxiety.

12 Working with anxiety

13 Working with anxiety

14 When mastery cannot be reached

15 How can we support mastery?

16 1. R E C O G N I Z E D I F F E R E N T W A Y S OF E X P R E S S I N G D I S T R E S S

17 Behavior has purpose Behavior has purpose and communicative intent. Behavior serves to protect myself and signal to others. Because of fear circuit and defensive behavior, children need adults to be interested, to help make sense of what is perceived as dangerous, and reduce behavioral activation that doesn't work. Joining: replace why you do that? with why did he do that??????

18 Even when behavior seems planned or is about something kids know not to do ask what does he/ she need to learn, and how can I help that learning? Remaining interested in children's learning protects against useless blaming and retaliation.

2. A C T I V E L Y C O N S T R U C T E M O T I O N A L S T O R I E S Emotions are not just static or hard-wired entities but alive and continually constructed phenomena that allow us

19 2. A C T I V E L Y C O N S T R U C T E M O T I O N A L S T O R I E S Emotions are not just static or hard-wired entities but alive and continually constructed phenomena that allow us to build a sense of our lives-- and our worlds. We construct meaning that confirm our feelings, and feel to confirm our meanings. Meaning making is a critical component of emotional life.

20 A faulty story Very challenged children perceive punishment as both rejection and retaliation. So they "fight back". They are judged to be wild and made responsible for others feeling constructs.

21 3. Build their disability story When children and teens are struggling at school, they need more than explanations: they need constructed narratives that include why learning is hard/ how their feelings and perceptions make sense/ and what they can do to feel better about themselves. Resilience is about moving forward in the face of adversity, and having a organizing story helps.

22 4. Advice to parents Scaffolding is different from suffocating: remember mastery. Children and teens must get to competence. Be sure to diversify what competence means, and respect your child s strengths. Pride can be a good quality: I'm so proud for you.

23 Development happens in time

upset (distress tolerance) Then you can do it(guiding).

24 Regulating support Try, try, try (motivation and desire) Accept that this might be hard (integration) Don't get too upset (distress tolerance) Then you can do it(guiding). Start with we can do this Sroufe, 1996 together (scaffolding).

25 Anxiety tricks you into staying scared/ tricks back Anxiety comes on fast but it is really hard to get it to go away. sensations, and conscious feeling states/ words to describe. Talk to your body reconciles Benefit of exposure (extinction): these seemingly contradictory forces. dosing/small steps/ small victories. Reinforcements that keep child active and

26 5. Advice to teachers At school anxiety becomes a learning disability: fear brain. Kindness, patience and informed teaching strategies promote mastery. It's important: convey conviction: this student can learn. Counter fear and loathing.

27 Keep moving students forward Scaffolding * NEW LEARNING What children already know and can use for more learning. Zone of proximal development, Vygotsky *

28 Give up shame Shaming never helps students who are struggling to learn not even the ones who appear to not care. Remember: fear circuits promote defensive behaviors. Students are protecting themselves from their own shame and misery. They need relief from shame, and direction to how to learn. What if student won't try? Reframe this: how can I find ways to repair motivation so this student will want to learn something useful?

29 Understanding where you are going, and why, is critical to ensuring that all feet are marching in the right direction. Northwest Area Foundation report, 2011 Disorganized, dysregulated students need predictable, reliable expectations. This is especially crucial for students who fear school, and feel anxious about being there. Educators must shift from this is how I do it but this works for this child. Individual educational plans are as good as educators willingness to focus on mastery and obstacles that block mastery of academics, but also of fear.

30 6. Advice to mental health providers (including anyone who supports wellbeing) Mental health massages minds and brains. Fear is massaged by confidence of safety; anxiety is massaged by perspective: make sure to keep danger testing with reality opportunities. Medications an provide some relief to fear and anxiety but only if learning keeps going. (LeDoux and Pine, 2016, Amer J Psychiatry)

Importance of executive functions Brain organizes from bottom up. Executive functions represent planful capacities and are often deficient when learning is hard. This adds to fear and anxiety.

31 Importance of executive functions Brain organizes from bottom up. Executive functions represent planful capacities and are often deficient when learning is hard. This adds to fear and anxiety. Executive function work must include attention to self functions too/ to building a robust and realistic sense of self/ I did it! Self deficits can cause two extreme reactions: dissociation/ checking out on self; and grandiosity/ exaggeration of self.

32 7. Advice to anxious students Remember, learning is at the center. Want to learn something. Hire adults to help: this is what kids do. Take charge. Be brave enough to say this is how I learn best. That is very different from avoiding or feeling trapped Tolerate disappointment and recognize that anger is one of the defensive behaviors that protect you and then doesn't.

33 Pete the cat manages

Does anxiety cause some difficulty for a young person you know well? What challenges does this cause for the young person in the family or school?

Does anxiety cause some difficulty for a young person you know well? What challenges does this cause for the young person in the family or school? John Walker, Ph.D. Department of Clinical Health Psychology University of Manitoba Everyone has the emotions at times. Signal us to be careful. Help us to stay safe. Most children and adults have mild