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Occupational Therapy and Emotional Regulation

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Navigating the intricate terrain of human emotions, emotional regulation emerges as a cornerstone skill, influencing every facet of our lives from childhood to adulthood. Unraveling the threads of emotional regulation unveils its profound impact on mood, concentration, relationships, and cognitive processes, offering insights into its pivotal role in fostering well-being, social competence, and optimal learning experiences.

Emotional Regulation

What is it?

Emotional regulation refers to “The ability to manage your own energy states, emotions, behaviours and attention, in ways that are socially acceptable and help achieve positive goals, such as maintaining good relationships, learning and maintaining wellbeing” (Shanker, 2010). For children, this looks like the ability to identify different emotions, what they mean, and choosing and utilising a meaningful response to communicate them. Development of “Emotional regulation skills take time to learn. It begins from birth and continues into adulthood” (Florez, 2011).

Emotional regulation is our own experience of emotions, how we understand them, and what we do to support ourselves to respond to them in a healthy way. When we can emotionally regulate, we can identify what we are feeling, and act on this feeling in a way that can make ourselves feel safe and secure. Self regulation is about making a dramatic difference in mood, concentration, and the ability to make friends, feel empathy, and develop the higher values and virtues that are vital to a child’s long term wellbeing.

What does emotional dysregulation look like?

Emotional dysregulation is a reaction or expression of an emotion that feels unsafe or unhealthy, to us and to others. These behaviours are expressions of a child’s inability in the moment to respond to everything going on in and around them – sounds, noise, distractions, discomforts, emotions.

Unsafe or unhealthy reactions can result from feeling overwhelmed, feeling scared of, unsure of, or confused by big emotions. Triggers to overwhelming emotions can be different for everyone and may be big or small. What can be difficult for some children, is finding the right or most appropriate response to different intensities of triggers.

Emotional Regulation and Relationships

Understanding our emotions is also key to participating in healthy relationships and social interactions, especially for children. As our emotional awareness and intelligence develops, we can better understand other’s emotions, and respond in a healthy way to support others. This supports the development of healthy friendships and relationships throughout our lifetimes. “…emotion regulation has been hypothesized to affect children’s social relationships … This ability can be thought of as a core aspect of good social skills as children must know when to appropriately engage with others (i.e., talk to or play with them) and when to disengage with them …This constant shift in communication and behavioural engagement and disengagement during social interactions may be easier for children who are able to regulate their emotions. Not surprisingly children who appropriately regulate emotions have been found to display greater social competence, better social skills…” (Graziano et al., 2007).

Emotional regulation and school learning

Emotional regulation is also an important skill that supports children’s school learning. Blair (2002) suggests that inefficient emotion regulation physiologically inhibits a child’s use of higher order cognitive processes (e.g., working memory, attention, and planning) in the classroom. The most frequent aspects of the cognitive domain that we see children and adolescents struggle with are:

Attentiveness
Ignoring distractions
Delaying gratification
Combining ideas
Sequencing ideas
Tolerating frustration
Learning from mistakes
Switching focus
Seeing the relationship between cause and effect
Thinking in abstract terms

It seems ‘common sense’ when you encounter any of these problems, to think that you should be focusing on that specific issue. Say for example a child has difficulty paying attention: It is tempting to think that they need exercises to strengthen this capacity. Occupational Therapists help to reframe by asking – what are the underlying factors? What can I do to strengthen physical and sensory demands of this task?

Strategies for a ‘Bottom-Up Approach’ to learning about emotions:

The Learning Pyramid, first devised by Williams & Shellenberger (1996), proposes that learning is incremental and that a child’s sensory integration plays a huge part in their development. The Learning Pyramid demonstrates the way in which our bodies ‘organise’ input from the world in which we live. Much like you can’t place the top stones without a solid base, every developmental stage stage relies on the strength and stability of the ones beneath it. Similarly, your child’ss sensory system forms the foundation for all their higher order skills.

When you support the way in which your child’s sensory system works, you are empowering them to feel success in their daily life, safe in educational settings and confident in the community.

Identifying different body clues and signals:

Occupational Therapy at Centre of Movement utilises a range of different strategies to support children to understand different emotions, by first understanding what they feel like within the body. Children develop awareness and an understanding of emotions on a body-mind level, acknowledging different emotions as sensations that appear in our body. This technique is called interoceptive awareness and is defined by “… the ability to identify, access, understand, and respond appropriately to the patterns of internal signal.” (Price & Hooven, 2018) When working with children and their families, interoceptive awareness is often termed as body clues, or body signals.

Mindful attention to body clues:

Occupational Therapy at Centre of Movement supports children to further their understanding of emotion-based interoceptive awareness through encouraging children to implore mindful attention to their own body clues. This may look like enabling the child to address and communicate what they are feeling and what it feels like in their body, at the time of therapy or in a reflection of a recent emotion or event. In this way, the child is encouraged to connect their knowledge about body clues to their own unique experiences.

Sensory strategies for emotional regulation:

Occupational Therapists at Centre of Movement utilise a range of sensory strategies to support children to feel safe, confident, and in control of their bodies and minds within therapy sessions. We understand that sensory strategies can support a child’s brain to re-focus on their environment and increase awareness in times of emotional dysregulation, and we utilise this knowledge to inform our interventions when supporting children with emotional regulation in clinic, and within their natural environments.

“Interdisciplinary evidence indicates that strategically activating each of the five major sensory modalities (i.e., sight, smell, hearing, taste, and touch) can increase positive emotion and decrease negative emotion.” (Rodriquez and Kross, 2023)

How do we bring it all together?

Working with the evidence above, Occupational Therapists at Centre of Movement support children to develop strategies that may support them in times of dysregulation, or mind-body dis-connection. As therapists, mothers, and daughters, we understand that children won’t always be able to draw on the knowledge that they need in times of stress and dysregulation. In respect to this, we can support children to develop person-centred and holistic strategies they can use and apply when in moments of dysregulation.