Sometimes, in therapy, there is a display of unpleasant emotions. Sometimes this is exactly what is needed, and other times this could have been handled differently, so that processing of the events happening could have been understood or much needed connections made.
When therapy is new, yet inexperienced situation, especially with smaller children, crying and tantruming can happen because of the uncertainty. At those times, it is the priority of the therapist to make the situation as comfortable as possible. This may take some time with certain children. The beginning of therapy is not the time to push discomfort because there is not yet a safety zone for the child. However, when the therapist is familiar with the child, and the child with the therapist, there are times when crying or tantruming is unavoidable and needs to be allowed to occur.
There is often a great affective disconnect , a difficulty with emotional signaling that can root from environmental issues such as severe deprivation or abuse or biological factors that limits a child’s capacity to interact fully with others (such as ASD children or children with disability involving motor planning, auditory, visual-spatial processing or sensory modulation abilities.) When there is great emotion and a limited ability to either respond to, comprehend, or navigate and orchestrate through our emotional states, these intense emotional states (emotional deprivation, fear, rage,neediness) are quickly linked to fight or flight reactions which ultimately are directly discharged through action.
Learning how to navigate or respond takes re-learning of missed developmental opportunities. Usually,this means nurturing the development that needs to be in place in order to handle automatic upset, however there are times when the child will resort to older, more familiar, more known methods to “navigate.” This may be one of those times when the therapist needs to allow a child their reaction and go through this with the child safely, allowing the child to experience safe, non-catastrophic results.
Let’s go back to the “Jack in the Box” learning theory (http://backmountainmusictherapy.com/2013/10/music-play-to-override-developmental-delays/). This theory described how a typically developing child learns in a healthy environment. The baby’s mother turns the handle on the Jack in the Box. The clown jumps out and the baby looks to it’s mother with uncertainty, sees it’s mother laugh with bright, inviting, affectionate eyes. The baby realizes that this is fun, this is a game, see how Mommy looks? The baby giggles back, and the scenario is replayed as Mom entertains the baby and receives affectionate laughter. The baby in turn, giggles, smiles and flirts with Mom to continue this emotional exchange. This turns into a rhythmic, back and forth cycle where the child learns what is catastrophic, affectionate, pleasant, and unpleasant. The more these type of interactions occur over time, the more the child learns what is pleasant or not, and as unpleasantness is greeted with comforting nurturance, the more the child is able to delay, reflect, comprehend, and navigate.
But what happens to the child that does not interact with it’s mother when the Jack pops out of the box? Perhaps the child has biological deficits which do not allow this interaction to proceed. Perhaps, due to severe deprivation, depression, or other environmental issues, the mother does not respond. What does the child do or learn? What happens to this child as time continues and needed interactions do not occur? The child develops no ability to process. When overwhelming emotions occur, action immediately takes place (crying, tantruming, etc).
By the time this child begins school and can not appropriately navigate, the immediate action (tantruming) is not only inappropriate, but also creates a chaotic and threatening environment to the child’s peers. This child will have to go back and learn this, but most likely not in the same environment as the original “Jack in the Box” baby. Some behavioral techniques may temporarily modify the action taken by the child, but the child still has not received what he needs in order to process further, future catastrophic emotion.
If the team working with this child never turns the arm of the Jack in the Box because the child will tantrum, and the Jack in the Box is avoided at all costs, what has the child gained? Perhaps measures have been taken to help this child learn, but the Jack in the Box is part of the daily curriculum. Those working with this child are afraid, and so the child is scooted out of the room each day. Now who is learning what? The child that has been appropriately prepared and is ready, but for this child, leaving the room daily gives him special attention he would like to continue. Therefore, tantruming is now a comprehended tool (and appropriate for the child to learn) to navigate with. It is not appropriate for the situation or others near the child. At this time, cranking the Jack in the box, allowing the child this situational tantruming, then gentle, non condemning, natural consequences, allows the child to learn that he is okay, the Jack in the Box is okay, but tantruming is not.
Antoinette Morrison MT-BC