The BEST Mental Health Practices for Infants and Toddlers | Dr. Karen Villa

“Parents tend to think that our kids can’t remember zero to five, so it doesn’t really matter what happened in zero to five. They are coding experiences from zero to five and what we call an implicit memory. So it’s like an unconscious memory and that will keep it down in body and in behavior, if they have bad implicit memories, they may not have access to them consciously, but they act them out in other ways.”

Dr. Karen Villa

Sr. John Dominic, O.P.: Welcome to Mind and Heart. We’re going to talk about balance strategies for ages zero to five. And my guest is Dr. Karen Villa;  back again, by popular demand and we’re going to unpack ages zero to five years old.

Karen Villa: There’s a lot of strategies in the zero to five-year-old range because that is a really important time for establishing self-control which is at the center of balance; that a child has the ability to control their reactions, their impulses, and their emotions. So I really think balance starts right away when a child is born and there are a lot of strategies here that a parent would continue to use throughout their child’s development, but they’re really important in that zero to five-year-old range. So we take sleep from the “Healthy Mind Platter” and infants are born on a twenty-five-hour cycle.  We adjust to a twenty-four-hour cycle, but when infants are born they come out of the womb on a twenty-five-hour cycle. So learning to regulate sleep from the very beginning is important. One way to do that is to say eight o’clock every night that’s when you go through kind of a bedtime routine.  Then that child just comes to know that twenty-four-hour day and that this is sleep time. And then that first year is really about soothing. So if an infant is crying or they are upset or they have any kind of need that a parent is really responsive to that especially that first year.  Then discipline doesn’t really start more till twelve months and beyond.  It becomes a different ball game at that point. So you would see as a child starts moving and exploring their world, they have a lot more reactions to it, they are so curious and into things, and you need to be able to tell them no, and they need to be able to accept that limitation on them.

So one of our interpersonal neurobiologists was a big believer in something that he called ‘floor time.’ And this is where you take time every day to get on the floor and just play with your child.  Let them lead it and you are just kind of following them around.  You know parents are in charge so much of the day and children feel helpless to that, so it’s nice for them to have a time where they’re leading their parents in play and this ‘floor time’ is really important to build attachment. So when parents and children have a good connection that’s going to establish a sense of security and help them to feel safe in the world and they’ll be much more balanced.  That’s why ‘floor time’ is so important.

Sr. John Dominic, O.P.: That’s really interesting; getting down on their level and rolling a ball, or just doing all those little things …

Karen Villa: Or getting a dollhouse and making up a story with characters or you know building Legos and all of those things that’s really important for a child every day that a parent is on the floor engaged with them and it goes a great distance to balance, I think. 

Then as they become verbal, and I would say even before they are speaking words, because children understand before they express, so they understand a lot more than we realize before they can use words to express it. One of the important strategies for balance is called ‘Name It to Tame it.’   So when you see a child having a feeling if you put a label on it, this helps them transition ‘big feelings’ for ‘out of body and into mind’ where they can become ideas that they can think about and talk about.  So, just labeling feelings is very helpful for a child in those early years.  

Sr. John Dominic, O.P.: Name It to Tame It,’ OK, ‘Teaching Self-Control’

Karen Villa: Which is really at the center of balance, right? So, this is something that parents just want to have as an overarching value system in those early years. So, it’s not “get control of yourself and don’t have that feeling” because that would cause a child to repress that affect and then it comes out in symptoms later.

Sr. John Dominic, O.P.: So when we talk about the virtue of meekness or something, which is the virtue that helps anger. So let’s suppose that they’re out of control of it having it angry about something. When we talk about meekness we say, “Okay, let’s walk away from the situation. Let’s count to ten, do something to kind of diffuse it but you’re not stuffing it or something.

Karen Villa: So it’s not just a demand for control, it’s helping them to regulate and helping them to learn to regulate.  You know, I often find myself talking to parents and kids, “You know, you’re feeling just got bigger than you and we need to kind of shrink it back down to size,” or “Your anger is in your hands because you want a hit or it’s in your feet because you want to kick and we want you to have it in your words.”  So that kind of spirit, I guess with strong emotion before the age of five is very helpful in achieving this state of balance, which I really think is a developmental achievement and it’s a learned skill. And these are ways that parents can support that.

Sr. John Dominic, O.P.: And just let them just like you said like ‘Name It, Tame It’  just to verbalize it and give expression to whatever.

Karen Villa: Right, and tolerate it. Help children to know that it’s going to pass. They’re not going to be feeling that way forever – in five minutes they’ll be feeling differently. So when parents are helping with this balance before five, when they deliver them to you all at the age of six, they are much better equipped to take in their learning and participate in it.

Sr. John Dominic, O.P.:  I remember Dr. Dan Siegel even talking about this too, that you are going to make all these parenting mistakes or even with teachers, I mean, I use it even as being a principal, sometimes you just kind of reach that point, but this is kind of what we’re we’re aiming for.

Karen Villa: Yeah, we have a way to work with all of these things.  You know, they call parenting the ‘impossible profession;’ psychology is the ‘impossible profession;’ and I think teaching is the ‘impossible profession’ because you can’t get it perfectly right all the time and you have to have a way to be kind and gracious with yourself when you make mistakes and then really for yourself and for your child use those mistakes as a teaching opportunity to learn some of these virtues and mindfully focus on them.

Sr. John Dominic, O.P.: Alright, are there any other strategies in that one?

Karen Villa: Well, accepting negative emotional states.  So, you know sometimes parents can get embarrassed that their kids are crying or they’re angry and you really don’t want to communicate that they’re doing something wrong just by having their feelings. This really is a recipe for later problems. And then you know you and I sometimes talk about this ‘Upstairs / Downstairs’ brain issue. And I think this is a very important concept for parents to know when they’re dealing with temper tantrums.  So kids will have what Dr. Siegel calls an ‘upstairs temper tantrum’ or a ‘downstairs temper tantrum;’ and the downstairs one is they’re just overwhelmed and they’re beside themselves and they need soothing and comfort, but the upstairs one is they’re having a large emotional reaction in order to get their way or to get something they want.  And the main principle with that is that you just don’t give in to the wanting.  You help regulate the emotion but you don’t give in to the wanting. Otherwise, you’re reinforcing that excessive emotion as a way to control and manipulate their environment.

Storytelling it and putting a narrative around things is another way to move those feelings up ‘out of body’ and ‘into mind.’  So stories that you know, talk about a difficult struggle like ‘sharing’ or ‘jealousy’ or ‘I’m too angry,’ and they put it in the context of children or animals with a narrative around it are very helpful in mastering these emotional states.  Kids who struggle, if they have these books around, they will be seeking them out and they will be asking their parents to read them and there are so many good ones out there that parents can use so it’s good to have those around because a story helps to put a structure around a difficult state. 

And then Dr. Siegel talks about a strategy called ‘Engage don’t Enrage.’  And because children are having such a hard time getting to this developmental achievement where they’re in a balanced and regulated state, we don’t want to flood them with our own emotion, we don’t want to discipline just out of anger because that kind of stress, a child can’t process their own emotion, let alone the overwhelming emotion of an adult who they’re trying to please and that they love.  So that’s an important one.  And then, back to the ‘Healthy Mind Platter,’ the physical piece – that when a child is emotionally or behaviorally dysregulated – it can be very helpful for them to do some physical exercise. So that’s a good one.

Sr. John Dominic, O.P.: So, when I mentioned this ‘walking away’ or ‘go doing something’ just to get away from the situation. So, this really is I mean, you know, sometimes we forget but you think oh, they’re young but this all these things that you said are so foundational and as we continue to unpack these in the different age groups we’ll be able to really see.  And I think the important thing, too that will remind parents, we have to keep saying this again, that if you missed one, you know, it isn’t over. You know, every day is a new day that’s the beauty of conversion, you know, every day is a new day and we can start afresh the next day.

Karen Villa: So I would add a caution to your point about how foundational it is.  Parents tend to think that our kids can’t remember zero to five, so it doesn’t really matter what happened in zero to five because they don’t have explicit memories about it, their memories don’t explicitly form until five or six.  But there is a way that they are coding experiences from zero to five in what we call an implicit memory. So, it’s like an unconscious memory and that will keep it down in body and in behavior, if they have, you know bad implicit memories. They may not have access to them consciously, but they act them out in other ways. So I would caution parents against thinking that children don’t remember those experiences from zero to five because they do. 

Sr. John Dominic, O.P.: They do, they just can’t, they don’t verbalize it, but it’s going to come out.

Karen Villa: It’s pre-verbal; they don’t have verbal access to it, but it’s still there. So that’s why you really want to use these strategies, intentionally.


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