Meltdowns represent total succumbing to Fight, Freeze or Flight behavior. A meltdown is a catastrophic reaction to stress where the individual loses conscious control over his or her behavior. The person becomes “disorganized.” The emotion is usually rage or overwhelming fear. There may be some short term intentional behavior, but there is a marked absence of sequential thinking (thinking about consequences). Characteristic of flight, freeze or flight states, thinking is almost exclusively in the very immediate here and now. Ross Greene, author of “The Explosive Child,” calls the state “vapor lock.”
Sometimes the person can stop on a dime if they get what they want, or some bigger threat comes along (the police show up), but often there is a slow and long duration calming down. Agitation can linger a long time, and some may have very unusual peripheral nervous system (sympathetic + parasympathetic) responses where rage can go on for an hour or longer.
More often though, thinking and actions take on a ballistic nature. That is, once launched, the behavioral action stream can no longer respond to input. Like a bullet, the behavior does not respond to directions – it just keeps going until something stops it or it just loses energy. Trying to stop the behavior feels like stopping a freight train. Your efforts to help often escalate the behavior. Trying to soothe or calm the person can feel like stopping a ship. This may be due to an overactive sympathetic response, or an inadequate parasympathetic response or both.
There can be a wild-fire, seizure-like quality to it as well. That is, it starts and cannot be stopped until the chain reaction just burns out or runs out of fuel. This is why psychiatrists often medicate people who have mood disorders and experience explosive behavior with anti-seizure medications such as Trileptal, Lamictal, Depakote, etc.
Tantrums on the other hand are deliberate acts of coercive behavior. They respond to what behaviorists call “Negative Reinforcement.” That is, removing the demand or limit makes the next tantrum more likely. So if your child throws a tantrum because you asked him/her to take the plate to the sink, and you respond by doing it for him/her and not asking again, you’ve made it more likely that the child will tantrum again to control demands or limits.
People have more mental control during tantrums than they do in meltdowns. They are capable of thinking of consequences. In fact, they tantrum to produce the consequences they want. This is different from a meltdown, where the after effects often include shame, embarrassment, guilt, and broken relationships (if not broken toys, computers and other things the person values).
What can be done to de-escalate behavior?
This model of intervention minimizes the sympathetic response by showing concern and empathy rather than meeting threat with threat. Also, the focus is on reducing demands on mental processing while the child is in the throes of the Fight, Freeze or Flight reaction.
1. Show concern: Slightly elevated, concerned and caring tone: “Are you OK? What happened?” He or she screams and vents and behaves irrationally, blaming, etc. We don’t confront his perception at that moment. Key words terms, concepts:
Attunement: You do not dismiss or challenge the person’s perception. The person must see you as helping, not threatening. The person wants to feel like you understand how important it is to them – regardless of whether the issues is or is not of real importance.
Measured: Your tone of voice conveys caring, not panic, urgency or desperation to get it to stop.
Few words: Use more tone of voice than words. Too many words overload an already overloaded brain.
Wait: You’ve asked, “What’s wrong.” Don’t rush or pressure the person to respond. Allow venting. Do not respond to idle threats, but take threats seriously (especially when dealing with violent persons). Don’t respond to invective or vitriol (nasty comments, attempts to get your goat).
Empathy: Reflect back to the child and what they said by paraphrasing (not parroting). Don’t correct them or judge. “Someone took your game?” “Someone threw a ball at your head?”
You’re just helping the person put it into words. The individual must believe you are there to help, not disbelieve, dismiss, confront or judge. Save the reflection and evaluation for later – perhaps much later.
Key words, terms, concepts:
“I wish”: “I wish we had more ice-cream” sounds better than “Sorry, there’s no more ice-cream.”
Slow everything down: Down-shift. Speak slower. Use few words. Don’t give lengthy explanations. Insert longer pauses between your words. Lower the volume of your voice.
Remember, you are communicating with the mammal brain. It understands fast movement, loud voices and a lot of words as a lot of actions – which translates into – threat.
2. Reinforce Calmness: Wait for little moments of calm before speaking. The child wants your help – or at least a response. While you are not unresponsive, you don’t talk or act much while the child is disorganized. You use your responding as a “reinforcer” or reward for calmness.
Wait for little moments of organized, focused attention and regulation. Stop speaking immediately if the person goes back to raging.
3. Sympathize with the child’s struggle: Let the individual know you know how hard it is. Don’t deny his/her feelings. Never dismiss, “Oh, you’re making too much of this. It’s not that bad.” “Oh man.” “That’s awful.” “You’ve been waiting so long.” These statements communicate that you are on her side, not a threat. This may be hard to do when your child has done something awful. Remember, you will deal with consequences and repair/restitution later. Not now.
Confidence: Reassure the child that they will be OK. The individual may think he/she is going to die, but you can’t be frantic. You have to act as if you’re confident everything will eventually be fine. You can say, “It’s OK,” but that may not be preferable. It may even aggravate. It’s better to speak through your actions – or lack thereof.
You communicate this message by not acting frantically and jumping into problem solving too quickly. Parents have a biological predisposition to act when their child send stress signals. The child’s sympathetic nervous system activates the parent’s sympathetic nervous system (see why it’s called the “sympathetic” nervous system). Your child’s behavior is punishing to you. It is meant to activate you. You have to fight the urge to take problem solving actions too quickly as they are too much for the child to process at the moment. You can be concerned, but you have to be the one that appraises the threat realistically.
But when you can’t prevent something – try to re-frame it as an opportunity. An investment in emotional resilience. Sometimes, there are no good choices. There is no more chocolate. We will have to wait until next Friday. These times present an opportunity for your child to experience bad feelings in your loving, empathic arms. This is as it should be. But it will not be easy. It may take a while and your child’s emotional wiring may be a cause or result of extreme neurochemical imbalance. Using the empathic, soothing approach alone may be especially difficult if this is the case. When in doubt, refer to the three step-model to de-escalate tantrums and meltdowns.
Source: Autism Parenting Magazine
