Change the Lens: Change the Life
The Nurtured Heart Approach and more…
Annie Lange, LMSW, ACSW
517 719 1523
Why are we here?
Why are we here today???
Describe relationships between trauma, brain function,
attachment, empathy and relational connection between
adult and children.
Discuss the neurobiology of the stress response.
Have a working knowledge of the thought cycle and its
effects on feelings and behavior.
Discuss concrete strategies to support attachment,
self/child regulation and healthy self-esteem, including
the Nurtured Heart Approach Model.
Change our Lens
Change the lives of Children and Adults
Every child is born with
beautiful potential
Potential Blocking
Caregivers can make
a difference…
Attachment Care Giving Video
Effects of Trauma & Stress
Adaptation vs Pathology
Build positive developmental pathways and competencies that support
current and future resilience.
Blaustein, Kinniburgh 2010
Core Concepts of Childhood
• Nurturing & dependable relationships = healthy childhood
•Humans hardwired to connect
•Attachment changes the brain
•Child development shaped by nature and nurture, biology and
Blaustein, Kinniburgh 2010
Core Concepts of Childhood Development
• Self regulation is essential for child development and life-long
•Balance of risk factors and protective factors determines level of
healthy development
Orlans, Levy 2006
Care giver’s developmental health
impacts child’s developmental health
The Developing Brain
The Developing Brain
The brain is a social organ and develops in the
context of relationship
Genes provide framework, life experiences
directs final construction
“Use it or lose it”
The first three years of life is most critical
Triune Brain
The Brain
Rational Brain
Mammalian Brain
Reptilian Brain
Adverse Childhood Experience Study
Adults who experienced at least four traumatic events in childhood have
increased risk of:
•Morbid Obesity
•Unwanted Teen Pregnancy
•Domestic Violence
Felitt and Anda (2003)
Trauma and Memory
Explicit Memory: non emergency memory,
logical, has words
Implicit Memory: expressed in body as
well as emotions, created by neural firing,
no time stamp, experienced as if in the
“NOW” moment
ADHD Disabilities vs. Hyper-Arousal
•Inability to be reflective – think before acting
•Selectivity: unable to focus and screen out important from the
•Continuity of Attention: inability to sustain attention and complete
•Self-awareness and self-regulation: not able to be responsive to
positive and negative reinforcement
The ability to change patterns of energy and
information in response to new experience
The hope of healing lies in the ability both
within the mind and between minds to modify
wired in painful and frightening experiences
Psychotherapy/care giving can be a mutual
engagement that can change both structure and
function of the brain= Neural Integration
Badenoch, 2008
Human Danger Response
Step 1: Danger Beliefs
“lens of danger”
Step 2: Body and Behavior Responses
“Fight – Flight – Freeze”
Step 3: Compromised Healthy Development
Self * Social * Cognitive
Blaustein & Kinniburgh 2010
Common Childhood Trauma
Perceived lack of power or control
Unexpected change
Feeling threatened or attacked
Feeling vulnerable or frightened
Feeling shame
Feeling deprivation or need
Intimacy and positive attention
Blaustein, Kinniburgh 2010
Attachment Healing
•Caregiver Management of Affect
•Consistent response
•Routine & Rituals
Blaustein & Kinniburgh 2010
Challenging Child Behavior
Triggering Adult
•Child’s triggered response
•Anger / Opposition/ Blame
•Demand for affection
•Patterns of approach and rejection
•Extreme response to stressors
•Reduced sense of efficacy
•Guilt/ Shame
•Shutting down or contradicting
•Being overly permissive
Blaustein & Kinniburgh 2010
Affect Management
•Self-monitoring skills
•Body ~ Thought ~ Emotion ~ Behavior
•Affect Management Skills
•Building a Support System
Blaustein & Kinniburgh 2010
Affect Management
Taking Care of Self
•Deep Breathing
•Muscle Relaxation
•Distraction / Movement (Tai Chi)
•Self Soothing / Self Care
•Thought Cycle
•Mindfulness/Thought Surfing
Thought Cycle
Thought Travel
Thought-based Principles
1. First Step: Awareness / Mindfulness / Attention
2. State of Mind not dependent on what is going on
3. 90% of time it is the thought not the event that determines the experience
4. Response Ability
5. Passenger or Driver of the Thought-Train
What is Stress?
Thought Story
Rule Book (agreements)
State of Mind
Understanding Triggers
Trigger: A reminder of a past event that can lead to same set of emotions and
Blaustein & Kinniburgh 2010
Attachment & Triggers
• Avoid or withdraw from Caregiver
• Overly clingy and unable to take in support
• Freeze
• Appear “manipulative” or try to control
• Conflict approach / avoidant behavior
Blaustein & Kinniburgh 2010
Muddy Mind
Wheel of Awareness
Siegel, Bryson 2011
Viewed through our Lens
1. Awareness on Purpose
2. Of Present Experience
3. With Acceptance
Thought Surfing
Thought Surfing
Identify Thought
Sit back and watch, don’t act, observe
Note the sensations
Be aware of triggers
Remember it is temporary, transient
Use a helpful mantra “This too shall pass”
Keep practicing
Steven Handel
Belleruth Naparstek
Change the Dance, Change the
Child: Attunement
• “I see you”, “I hear you”
• Attunement is a moment to moment, day to day process
• Attunement fosters co-regulation
Consistent Caregiver Response
• Active Listening
• Self Regulation
• Focus on Positive
• Consistent behavior management
Blaustein & Kinniburgh 2010
Care giver Strategies
 Star
(Bailey, 2001)
The Nurtured Heart Approach
• Utilizes the challenges and intensity to create success
• Creates first-hand success in the “NOW” moment
• Helps create a new portfolio for the Child
The Nurtured Heart Approach
The approach has three basic aspects:
Super-energizing experiences of success.
Refusing to energize or accidentally reward
Providing a perfect level of limit-setting and
The adult in a child’s world is the
ultimate prize !
When do we give the $100 bills?
The Three Legged Approach
#1 I will purposefully create success for the child
#2 I refuse to be drawn into accidentally
rewarding and energizing the negative
#3 I will provide a true consequence when the
rule is broken
More than catching kids being good!!!
“Toll Booth Man”
Techniques for Energizing Successes in Children
Active Recognition – a “snapshot”; noticing and describing
what’s going on in this moment.
Experiential Recognition – ‘The Big Picture’; Connecting the
positive behavior that you notice to values.
Proactive Recognition – Noticing when rules are not being
Creative Recognition – ‘Creating Success’ where it isn’t
ordinarily seen, or doesn’t ordinarily exist. Shamu
Time Outs
• Provides Child space to calm
from distressing moment
• Used for impulsive or unsafe
Blaustein & Kinniburgh 2010
Trauma & Limit Setting
• Reduce need for limits through limited choice
• Compromise
• Choose your moments (flipped brain)
• Be aware of Triggers
Blaustein & Kinniburgh 2010
Limits as Triggers
• Fear of abandonment & rejection
• Always name rationale for limit linking it to behavior
• Moving on (mulligan)
• Making adaptations to limits for specific triggers
Blaustein & Kinniburgh 2010
• Start small and build
• Start with reinforcement rather
than limit setting
• Don’t start with the most difficult
Blaustein & Kinniburgh 2010
Build Routine and Rituals
“I’ve learned that people will forget
what you said, people will forget what
you did, but people will never forget
how you made them feel.”
- Maya Angelou
To your Greatness!!
Annie Lange
Clinical Social Worker
Nurtured Heart Approach Advanced Trainer
[email protected]
517 719 1523
Change the Lens, Change the Life
Badenoch, Bonnie (2008) Being a Brain-Wise Therapist; A
Practical Guide to Interpersonal Neurobiology. New York,
W.W. Norton & Company, Inc.
Blaustein, M. and Kinniburgh, K. (2010) Treating Traumatic
Stress in Children and Adolsecents, How to Foster Resilience
Through Attachment Self-Regulation and Compentency. New
York, NY: The Guildford Press.
Forbes, H. and Post, B. (2006) Beyond Consequences, Logic and
Control, Boulder, CO: Beyond Consequences Institute, LCC.
Glasser, H., Easley, Jennifer (2008) Transforming the Difficult
Child: The Nurtured Heart Approach, Nashville, TN:
Vaughan Printing.
Glasser, H., and Block, M. (2007) All Children Flourishing,
Igniting the Greatness of Our Children. Nashville, TN: Vaughan
Change the Lens, Change the Life
Hendrix, H., and Hunt, H., (1997) Giving the Love that Heals: A Guide for
Parents. New York, NY: Pocket Books.
Hughes, Daniel A. (2009) Attachment Focused Parenting. New York, NY:
W.W. Norton & Co. Inc.
Hughes, Daniel A. (2006) Building the Bonds of Attachment: Awakening
Love in Deeply Troubled Children. New York, NY: Jason Aronson
Orlans, M., and Levi, T. (2006) Healing Parents: Healing Wounded Children
Learn to Trust and Love. Washington, DC: Child Welfare League of
America, Inc.
Pransky, J. (2008) Somebody Should Have Told Us (Simple Truths for
Living Well). New York, NY: Strategic Book
Purvis,Karyn B., Cross, David R. and Sunshine, Wendy Lyons (2007) The
Connected Child. New York, NY: McGraw Hill.
Siegel, Daniel J. (2003) Parenting from the Inside Out. New York, NY:
Penguin Group.
Siegel, Ronald, (2010) The Mindfulness Solution. New York, NY: The
Guilford Press