500 Terry Francois Street

San Francisco, CA 94158

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Eileen Devine, LCSW

Therapist & FASD Consultant

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July 31, 2019

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The Neurobehavioral Model

October 30, 2019

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Cultivating Empathy

May 25, 2019

 

A mother once described a situation to me in which her 10-year-old daughter with neurobehavioral challenges impulsively threw a cup of water on another child after a disagreement. The two kids had been on the way back to class after recess. The mother’s voice was a mix of astonishment and resignation as she related how her daughter initially did not see anything wrong with her actions.

 

The daughter was upset and frustrated, unable to see outside of her own perspective.

 

The mother, in supporting her daughter in growing her empathy skills, asked the 10-year-old, “How do you think your friend felt when you threw the water on him?”

 

Without hesitation, her daughter replied, “Wet.”

 

The daughter’s response was a concrete (and admittedly, accurate) answer to a question that was seeking an abstract reply. How did your friend feel? It was only when the mother walked her daughter gradually through the process of understanding how her friend may have emotionally felt in this moment — from a relational and feelings standpoint — that her daughter began to show regret and sadness over what she'd done, and sincerely articulate a need to apologize to her buddy.

 

The daughter was able to feel her friend’s feelings eventually, but not without a great deal of added support.

 

It certainly didn’t seem to come naturally. 

 

And this is a concern I encounter often in my work with parents, a sometimes creeping worry that might be sensed or observed, but rarely verbalized for fear of what it means to put this particular apprehension or belief out into the world.

 

But there it is anyway:

 

“I don’t think my child is capable of empathy.”

 

By the time children reach a certain age, empathy is a trait they’re expected to hold, one that comes automatically in most situations and without prompting. When it doesn’t, when even gentle prodding to see things from another perspective fails to elicit a response, we as parents can begin to think of it as a permanent character flaw – that the child might be innately oppositional, uncaring, and selfish. That he or she would show concern for others if they simply wanted to. That this lack of concern for others is an intentional choice.

 

It can be frustrating and heartbreaking, a distressing belief, as a parent, to hold about your child.

 

We immediately spiral into a customary line of questions familiar to parents raising children with neurobehavioral challenges:

 

What will this mean for them as an adult?

 

How will they ever have meaningful relationships?

 

If they can’t think of others first…seemingly EVER…where will they end up?

 

The possible outcomes for children incapable of empathy can be scary. Restricted residential care, prison, or some other form of social isolation are some of the outcomes parents I work with begin to consider as inevitabilities in their child’s future.

 

But what is empathy, really?

 

The word "empathy" comes from the Greek em [meaning: in] and pathos [meaning: feeling]. Empathy means being in another’s feeling — feeling what they’re feeling. Despite what we all tend to believe; empathy is not an innate trait that we’re born with. It is an abstract cognitive skill that matures over time with coaching and support from the adults around us. It requires the recognition that others hold a different perspective than our own and from there, take ourselves out of our own perspective and experience and take on theirs.

 

It requires cognitive flexibility, which translates to the ability to consider another’s perspective as possibly having value, or an ability to shift gears cognitively in such a way where we can let go of what we had believed to be absolutely true and hold room for the idea that perhaps there’s another way of feeling. 

 

“Putting yourself in someone else’s shoes” is actually a cognitively complex skill, and for that reason, many children with brain-based differences have great difficulty with practicing it successfully.

 

But when you consider the supervision we expect to provide toddlers and preschoolers as they begin to move from parallel play into more mature relationship with peers, that supervision is centered squarely on supporting those children in growing the skill of empathy.

 

We might pause their playing and ask them intentional questions, such as: “How do you think that made your friend feel when you hit her instead of using your words?”

 

We walk them through the process of taking on someone else’s feelings because, as young children, they are not yet capable of doing this on their own. In fact, we take the time to walk children through the process of being in another’s feelings over and over again, until they’ve learned the skill and can, over time, become more adept at practicing empathy independently.

 

So, how can we begin to support our child in building this skill if it's one in which they are still lagging behind, long after preschool age? The first step is to recognize that it's not a character flaw, it is a result of their brain working differently. That makes it difficult for them to think abstractly in the way empathy requires. It’s about making the interaction or the event or the misunderstanding more concrete, helping our child come to an increased understanding of others' experiences. It requires circling back to this skill and conversation over and over again, knowing that empathy does not develop overnight, but that every conversation adds to our child's personal development of this skill. 

 

It's not just the child

 

Teaching children the skill of empathy also requires us, as parents or caregivers, to model empathy for them in ways that might be difficult when raising a child who exhibits particularly challenging, explosive, disrespectful and/or hurtful behavior.

 

True empathy, the kind that comes when you’re a parent, means temporarily letting go of the idea that our frame of reference is the one, true, “right” perspective, and allowing ourselves to feel what our very challenging — and challenged — child is feeling. This is where the difficult part of practicing this level of parental empathy comes in: during those exceptionally stressful moments when your child is exceedingly dysregulated, maybe having torn their bedroom apart; spent the last hour calling you awful names; thrown a game controller at the TV; punched a hole in the drywall — it means understanding that the unacceptable and challenging behavior is communicating to you the profound levels of pain and discomfort your child is experiencing in that moment. 

 

It means shifting our perspective to one that sees the troubling behavior as a symptom of illness or disability versus intentionally willful behavior that is deserving of punishment. It might mean saying very little or even nothing in the moment (knowing that lecturing or even minimal talking can tend to cause further dysregulation), but instead using our own moderated physical presence and measured regulation to help our child find a place of calm again. It’s being aware of the story we are telling ourselves (what we hold onto as the “true” perspective) and allowing ourselves to lean into our child’s story in that moment, tuning into what they need to regain their calm.

 

Practicing empathy is one of the foundational underpinnings of this neurobehavioral approach to parenting. It doesn't mean simply excusing inappropriate behavior, but rather understanding it, so it might then be addressed more successfully at a later time.

 

It means temporarily suspending our need to get our concerns on the table and to instead tolerate feeling with our child when everything in our being might be telling us to create distance.

 

When the storm has passed, and your child has regained calm, this is the opportunity to circle back to talk about what happened, another step in helping them cultivate their empathy skills. In this circling process, the key first step is to again lead with empathy ourselves, so as to model this skill even further. By suspending your need to lecture them about the behavior and first show them empathy, you’re helping to teach them the skill and the value of it. Getting your concerns on the table can come, but not before practicing and demonstrating empathy first.

 

What does this look like, exactly?

 

It means first letting your child know you recognized they were experiencing pain and distress and that you’re sorry to see them hurting so much, that you know that their behavior does not reflect who they really are. It means asking if they can tell you what was so upsetting for them in that moment, or moments, leading up to the meltdown. Many kids struggle to reflect on what-led-to-what and to articulate this, but that’s fine, by leading with empathy yourself, you are teaching — and reinforcing each time you do it — that despite the hurt their behavior caused, recognizing the feelings of others is still important.

 

Interested in learning more about how to identify the brain tasks your child has difficulty with or about the work Eileen does with parents and parenting with a neurobehavioral approach? Visit fasdnorthwest.com and reach out to her directly. She’d love to hear from you

Eileen Devine, LCSW works in Portland, OR as a therapist supporting parents of children with special needs. She is also a consultant for families impacted by FASD and other neurobehavioral conditions through her private practice, FASD Northwest, working with families nationally and internationally. She lives with her husband and two amazing kids, one of whom happens to live with FASD. For more information, visit fasdnorthwest.com.

 

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