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Theories of love, relationship,

communication and positive

behavior support

Ailsa Wonnacott, DPSNSW

Margaret A. Moore, Ed.D

Premise

� PBS definition – Koegel, et al. (1996)

� Reduction in problem behavior

� Rooted in behavioral science

� Emphasis on person centered values

� Increase in quality of life (Singer, 2001)

� Individual’s participation and satisfaction with life

� Impact on the team, family, community

� The success of a PBS plan is contingent on more than behavioral manipulations and our goals are broader than reduction in problem behavior.

Expanding our understanding of context

� Behaviors are often discussed in this context.

However, there are many other facets to any given

human situation.

Environment

Relationship

Behavior

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For a moment…functional assessment

� Environment

� Relationship

� Individual

� Motivation

� Behavior

� Antecedent

� Behavior

� Consequence

� We use antecedent manipulations, environmental

forecasting, address contextual fit with family and

staff members as a part of plan implementation.

� In addition, we often review quality of life

indicators in relation to Maslow’s hierarchy of

needs (MANSA, 1999)

� We evaluate motivation and cause of the

behavior.

However, behaviors are contextual

� There are a large number of influences on context that are

powerful in terms of how our knowledge of these affect

our vision of the person and our planning.

� Cultural – subculture, tribal, spiritual

� Forms of empowerment – relationships to power

� Inclusion – Kunc’s writing focuses on the need for

belonging as more primary than meeting one’s physical

needs

� Learning, memory, and experience

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The evolution of the human brain

� Paul D MacLean’s model of the triune brain

explains the functional traces of evolution within

the existing structures of the human brain.

(MacLean, 1964)

� Ian Tattersall-the human brain was built up over

the ages, structure upon structure. Some inherent

contradictions may result from this. (Tattersall,

1997)

The Brain

The reptilian brain (Lewis, Amini, Lannon, 2001)

� Reptilian Brain or R-Complex-sometimes referred to as the Brain Stem

� Mid brain-involved in vision, eye movement, hearing and body movement.

� Pons-motor control and sensory analysis also involved in level of consciousness and sleep.

� Medulla oblongata-maintenance of basic functions such as breathing, heart rate and blood pressure.

� Cerebellum or “little brain” functions are related to coordination, movement, posture and balance. Large number of neural connections to cerebrum. Has role in learning and automatizing motor tasks, makes predictions about how to perform tasks efficiently to prepare other areas of the brain for optimal performance.

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The limbic system

� Thalamus-sensory and motor functions; relays sensory information to the overlying cortex system-almost all sensory information synapses here.

� Hypothalamus-involved in homeostasis, emotion, hunger, thirst, circadian rhythms, autonomic nervous system and pituitary gland. The “Sergeant Major” of glands, controls pituitary, thyroid, adrenal and gonad.

� Amygdala-involved in memory, emotion and fear.

� Hypocampus- involved in memory and learning and recall of spatial relationship in our environment. Transfers information into memory. It is very vulnerable to stress.

Cerebral Cortex

� Has 2 hemispheres connected by the corpus callosum

� The structures are similar, functions may differ but mental processing is a shared activity-no-one is either left or right “brained”.

� Left hemisphere involved in logical/sequential analysis, computation and direct recall of facts, verbal communication, language, grammar and vocabulary.

� Right hemisphere involved in processing social emotional functioning, non-verbal communication including face recognition and the quality of communication (pragmatic language, prosody, tone of voice etc), visual imagery, intuitive analysis, music, spatial skills and computation skills (not direct fact retrieval). The right brain is crucial to the process of attachment and bonding, activation of the Social Engagement System and affect regulation.

� The right brain determines how the left brain will act.

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Why brain structure is important

� Brain structure and brain response are elements of

an individual’s internal context that affect

behavioral planning.

� The brain is an information processing structure

that receives information from the CNS, and in

combination with the CNS, supplies information

about the safety of the organism.

The Triune Nervous System

� Nervous system originally evolved as a survival

system (Immordino & Damasio, 2007) to:

� Maintain physiological balance

� Initiate threat response behaviors

Polyvagal Theory (Porges, 2004)

� The “first” nervous system, the parasympathetic nervous system-decreases heart rate, breathing and adrenal function-its behavioral strategy is freeze or faint-this is the most primitive threat response behavior.

� The “second” nervous system, the sympathetic nervous system-increases heart rate, breathing, adrenal function-its behavioral strategy is fight or flight.

� These systems are carried in a conduit known as the vagus nerve.

� Brainstem- contains the physiological management system and is the location where the “bundled” nervous system enters the brain.

� The nerves are un-myelinated-a layer of electrical insulation.

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A third system evolves…

� Only mammals have this system and it is most evolved/complex in primates, especially in humans, carried in the vagus nerve

� Concept of Social Engagement System, a function of the Ventral VagusComplex (VVC). The system evolved as a highly sophisticated form of defense whose behavioral strategy is to engage with other people.

� Nerves of the VVC are myelinated and innervate the muscles of the head, face, eyes and middle ear to produce facial expression, tears, focused listening, head turning and eye gaze, vocalizations, and chewing.

� VVC controls both engagement and disengagement.

� In order to function the system must inhibit our more primitive strategies for ensuring safety (Porges, 2004).

� We risk assess people by reading their non-verbal communication. A neural circuit actively inhibits the areas of the brain related to the 4F strategies. The assessment process happens more quickly when we see familiar people

4 F’s

Parasympathetic

nervous system

Freeze or faint

Social engagement

system

Friendship

and withdrawal

Sympathetic

nervous system

Fight or flight

When all else fails, dissolution.

� Process of dissolution (John Hughlings-Jackson 1835-1911)

� Our most evolved defense mechanism social engagement activates first to ensure safety through relationship. If this fails the next most evolved system activates to ensure safety through fight of flight.

� If this fails the oldest reptilian system activates as a last resort and feigns death (freeze/faint). It is thought that in situations where the organism perceives imminent death this response may inhibit the physical and emotional impact of the experience.

� Have you ever seen this?

� Let’s talk more about social engagement.

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Let’s talk more about social engagement

� There are two main processes in Porges Social

engagement system, neuroception and

interoception.

Neuroception-evaluating YOU

� Ability to read others facial cues and body movements to determine if a person is “safe”.

� Learned in infancy as a result of consistent attuned care.

� Leads to attachment to the care giver and thereby the ability to form social bonds with other people.

� The process of attachment involves the infant gazing at and tracking her care givers pupils (Schore 2003, p.67). Through this engagement infants are able to co-regulate their internal state with that of their caregiver.

� Co-regulation is a physiological state whereby infant and caregiver co-regulate both their endocrine (hormone producing glands located in the brain and organs throughout the body) and autonomic nervous systems (Hofer, 1990, p.71).

� Our future regulatory capacities are established by our early social and emotional experiences.

Interoception-evaluating ME

� Includes conscious feelings and unconscious monitoring of internal body state.

� Uses a feedback system whereby sensors located in the internal organs communicate with the brain (“Level 3 systems check”).

� The brain interprets and processes the information in the context of the information it has gathered about the environment (especially other people) and organizes a response.

� Motor pathways communicate “response orders” back to the organs to change their state.

� The information is categorized and associated with similar sensory information and stored as “memory” which will allow it to speed up response time in the future-we’ll come back to this when thinking about “memory”.

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Evolutionary and developmental processes address homeostasis

� Central nervous systems functions as the regulatory body

system that processes internal and external information to

determine if all systems are go…

� Attachment and bonding processes assist in this

regulation

� The sense of safety and security is the first flow

experience (Csikszentmihalyi,1990)

� Loss of organism sense to the larger experience/activity

� Ability to release need for monitoring of relative safety

� Even in perfectly functioning intact systems, the complexity of the central nervous system results in incomplete information at times.

� In people who are habituated to high stress or have a history of trauma, the CNS (the parasympathetic and sympathetic – body systems) may override the social engagement system, as the CNS does not process a sense of safety in the same way (seeks familiarity/regulation). This means that intentional assessment, time, and planning are needed to assist a person in easing and restructuring their CNS responses.

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Defining stress and trauma

� Stress is defined as “a specific response by the

body to a stimulus, such as fear or pain that

disturbs or interferes with the normal

physiological equilibrium of an organism”

� Trauma is “a body wound or shock produced by

sudden physical injury, or an experience that

produces psychological injury or pain.” (Random House

dictionary, 2009)

� Identical physical experience to clinical shock

Trauma and memory

� Memory does not work like a movie. Information is stored more like an emotional imprint comprised of pieces of information associated with the level of arousal we experienced related to them. It’s the level of arousal that the felt sense is aware of as a body sensation.

� So, healing trauma does not require accurate recollection or re-visiting of the traumatic event because the memory is stored in the body it can be physiologically discharged without the need to re-experience the trauma. Somatic psychology is a wide field with various approaches to the physical discharge of trauma in a holistic way-not just a head up approach.

Trauma and emotion

� Emotions direct our reasoning and in turn our decision making process to the category of knowledge most relevant to the current situation based upon past experience and this may or may not be accurate given the nature of memory.

� Our repertoire of behavioral options is therefore in service of our emotional needs and the decisions we make are driven by knowledge categorized by emotion and arousal rather than logic and reason or even an accurate sequential recollection of a past event.

� It is important to recognize that between stress and behavior is an emotion, and that the process of recognizing and responding to situations is essentially emotional and social in nature (Immordino and Damasio).

� Compromised social and emotional skills leads to poor decision making and impaired logical reasoning.

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Emotional decision making

• I feel tension in this fast, heavy traffic because I

am scared I will be hurt in an accident. It’s all the

fault of these other crazy drivers so I need to

make sure I go even faster than they do so they

can’t cut in front of me and get the better of me.

• What can we do for this person?

Where is the information coming from?

� The emotional brain turns the internal body sensation into an emotion which the rational brain will then translate into a thought, concept, judgment or idea and then into a strategy for meeting whatever it perceives it needs in order to regulate in the context of the environment. The components of felt sense and memory collide in the decision making process.

� Rather than analyze the behavior in a traditional functional assessment format, to analyze using physiological, social, emotional, and thought patterns makes much more sense.

� Environment

� Body

� Emotion

� Thinking (evaluating and strategizing)

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Cycle of events reaction CNS

� DaMasio (2004) indicates that one can’t be in 4 f’s and learn

� Between stress and behavior is emotion -- that emotion is structured in past experience (social engagement system and regulation of it is learned in that structure, so it is likely not perfect

� As memories are not movies, we actually store this information as� Physical states of arousal

� Snapshot pieces of information, which may or may not be accurate

� Memory as symbolic

Body/Mind

� Trauma research indicates multiple paths can

reach the traumatized person, that sense memory

processing, independent of rational-emotive

therapy can have some effect

� We know that soothing the CNS promotes healing

(Boriskin,2005, Gentry, 2003)

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Relevance of CNS context

� Not addressing this CNS context is bad, very,

very bad.

� If we are not addressing these things we are likely

retraumatizing or acting against or discounting

impact

� Exercise – feel it in my bones, on the tip of my

tongue

Some practices that honor these underlying causes of behavior

� Resilience

� Nonviolent communication

� Person centered planning

� Flow

� Restorative justice

� Somatic restructuring

� Body psychology

� Positive psychology

Resilience

� A positive behavioral adaptation to significant adversity, stress or trauma.

� Resilience process = stressor > cognitive appraisal (can I cope?) > development of a strategy (options are to adopt an external focus to problem solve, an internal focus to manage emotions, social focus to get help from others or a combination of these).

� Many children who are raised in adverse conditions such as poverty, wartime, social inequality develop destructive behaviors, but some children are more resilient to these conditions.

� Children who are raised in a culture where punitive or infrequent physical contact is the norm show higher levels of stress and aggression than children who have comforting attentive care givers and live in a culture where positive physical contact is typical.

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Resilience

� Traits of resilient people and communities include; see problems as opportunities for growth, have the ability to make realistic plans and take steps to carry them out, have a positive self-image and confidence in their abilities, good communication skills, mutually supportive relationships with others, good problem solving skills, the ability to manage strong emotions.

• Underlying protective processes that support resilience include nurturing supportive parents, positive relationships with the community and positive school experiences.

� Resilience is a dynamic quality rather than a permanent capacity.

Non-violent communication practices

� All behavior is in the service of our needs.

� The primary purpose of the interaction is connection between the two people for every communication.

� The person with the most awareness is responsible for the relationship.

� Attachment to outcome and strategy are flexible and separate.

� Imposing your will on another person is the act of breaking the connection.

� A “no” to one thing is a “yes” to something else. Our role is to find what the yes is.

� Everyone in the communication is entitled to having their needs met. (Rosenberg, 2003)

Person centered planning

� The purpose and primacy of person centered

planning in PBS is to understand and address

these other contextual elements.

� If you are doing a behavior plan for an individual

without creating and fully implementing a person

centered plan, you are not doing PBS.

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Styles of person centered planning

� MAPs

� PATH

� Frames

� ELP

� Circles of support

Flow experiences Csikszentmihalyi, 1998)

� Flow is “the mental state of operation in which the person is fully immersed in what he or she is doing by feeling of energized focus, full involvement, and success in the process of the activity”

� Optimal experience for learning� The doing is the reward as there is constant feedback in the flow

experience

� Not easy, can be quickly disrupted

� It is the intentional restructuring of attention and mental focus and allows for routine daily activities to become opportunities for an optimal experience.

Components of Flow

� Clear goals

� Concentrating and focusing

� A loss of the feeling of self-consciousness

� Distorted sense of time

� Constant feedback from the experience

� Balance of ability level and challenge

� A sense of personal control (Csikszentmihalyi, 1990, 1998, 2002)

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Restorative justice

� Justice is a basic human need (Taylor, 2006).

� A model of repairing harm (often criminal) based on not what rule/law is broken, but how to repair the harm. It works under the premise of collaboration and compromise. Restorative justice addresses the harm to the community as a whole rather than to an individual person.

� This practice has been used with people in prison, schools, and with a large variety of diagnoses.

(Mara Sapon Shavin, 2001; Tom Cavanaugh, 2007)

This means there is a need to examine the

individual’s, one’s own behavior and others in relation to the plan� 4 f’s

� Resilience information

� Person centered planning

� Communication practices� Verbal

� Nonverbal

� Lack of congruence of verbal/nonverbal information –NVC support of all need present – imposition of will breaks connection

� Body support

� Mind support

Self-regulation

As a primary need

As balance of body/mind regulation

sensory, emotive, intellectual, experiential information is all involved

Felt sense – the internal and external conditions that blend to create experience

Neuro and intero- ception – monitoring of safety external and internal (via organ/digestive/pulmonary) states

And beyond this is suspension of own immediate need to the betterment of the community

Balance of group needs/dynamics

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Group responses parallel individual seeking homeostasis (Alfs, 2005)

� Individual responses mirrored by system responses

� Systems/societies act as whole

� Mechanisms are nested – individual in culture in

relationship to group as well as self

� Paradigm shift – ordinary folk just changing mind

� Executing Personal control

� Change head needed

So, the day-to-day questions are:

� What is your ability to sustain and support

behavioral momentum?

� How are you energetically contributing to or

detracting from group/relationship?

� What supports you to sustain and support yourself

as a positive contributor?

Guiding people is what is happening

� Foods, meds, physical is incidental.

� This and behavior are most of what we measure… true or false.

� Measure community access – went to library… is this engagement

� Developing a satisfied team –

� Intrinsic rewards in human service systems

� Making dinner is not necessarily intrinsically rewarding …

� Transforming routines into personally meaningful experiences by setting goals/rules

� How are you defining success… did they eat/ did they relate and commune the whole time…

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Questions

margaret.moore@bvsd.org

awonnacott@aclboulder.org