Over The past weekend my wife and I went to see a movie, in a movie theater! The movie, “In the Heights “directed by Jon Chu with Music by Lin-Manuel Miranda is a celebration of a community, their lives, struggles, failures, and successes together. We were fully vaccinated but still had our masks in our pockets, not quite sure whether we were following the new rules of what was “Normal".
Since last October in the midst of the COVID – 19 pandemic Debbie, Jackie, Nami staff, and I have been meeting PREDICTABLY on Tuesday afternoons around 2 PM to talk about, plan, and draft our COVID -19 Toolkit based a model developed by Bruce Perry, MD at the Child Trauma Academy.
The Key take home point of the model is the importance of creating and sustaining PREDICTABLE, MODERATE, AND CONTROLLABLE relationships with ourselves, our kin, and our community to build Resilience rather than Vulnerability in our ability to deal with Stress. We have highlighted Tools and Habits of Daily Living that impact our Stress Response System and enable us to be better Regulated, Related, and Reasonable.
In this issue of the newsletter, as our community moves toward the goal of community immunity with effective vaccines we would like to highlight with you once again the items in our toolkit. We will emphasize core bullet points for each tool in the Toolkit and selected references.
Our first tool in our Toolkit was Structure
STRUCTURE is important in our lives and in our HABITS of daily living. These habits are structures developed and built together attuned to the specific environments of our experience over the course of our lives and personal relational history. These Predictable, Controllable, and hopefully Moderate structures are learned in social context, are developmentally attuned to different age groups, and provide safety, predictability, and trust. These Structures allow us to be reasonable and celebrate diversity and creativity in our community.
Talt, Veronika Ph.D. (2020). The Pandemic Toolkit Parents Need. Psychology Today
Perry, Bruce. Patterns of Stress & Resilience: Neurosequential Network
See our Newsletter Part I Structure for other age specific recommendations.
Ø creating structure is a work in progress and not a fixed destination.
Ø a developmentally attuned structure provides safety, predictability, and trust for us to explore, experiment, adapt and create.
Ø we thrive, particularly in adverse times with structure, predictability, and routine.
Ø routines are comforting, they give a design to our lives. Routines give us a sense of control and predictability which allows us to regulate, relate and reason.
Our second tool in our Toolkit was Kinship and Core group.
Bruce Perry states, “we are dependent creatures unavoidably interdependent on one another.” In his work, Perry, addresses the importance of human social connections in the management of stress. Not having predictable and safe social connections with one’s family and kin group can make our Stress Response System respond as if we were under mortal threat. What soothes and lessens social pain and deactivates the Stress Response System is the warmth of the human touch and connection. Belonging is essential to our survival.
Cacippo, John. How to cope with loneliness |Think Big
Cacippo, John. The lethality of loneliness:
Making 'Social' a Superpower in the Classroom - Matthew Lieberman
“Social Pain” is more than a metaphor. A broken heart is real.
See our Newsletter Part I Structure for other age specific recommendations.
Ø loneliness as a social pain is as real as physical pain and can affect one’s physical and mental health.
Ø when you perceive your social world to be unpredictable and socially unsafe, it activates the Stress Response System.
Ø during the pandemic when we are being asked to isolate, be socially distant, and quarantine we need to be thoughtful and creative in order to alleviate the stress caused by loneliness.
See our Newsletter Part II Kinship and Core Group for other age specific recommendations.
Our third tool in our Toolkit was Socialization.
Babette Rothschild, a clinician who works with people and communities who have undergone trauma, describes the social nature as “our relations are woven in, around, and through the fabric of our beings and intwined and in everything we do.”
In these last two tool kits, importance of providing a shared safe structed, Predictable, Moderate, Controllable environment within our family, kindship and community.
Murthy, Vivek H. (2020) Together: The Healing Power of Human Connection in a Sometimes-Lonely World. New York, New York: Harper Collins Publisher.
This publication gives an overview of the importance of community.
See our Newsletter Part III Socialization for other age specific recommendations.
Ø learning happens in the context of relationships and that within the context of social bonds we develop the motives and values that guide our lives.
Ø what we learn in the context of those relationships impacts outcomes. Our individual, community, and natural responses to COVID-19 crisis has made this very clear.
Ø building positive, trustworthy, and safe relationships in our family, our clan, in our community is essential for growth, creativity and resilience.
Ø when you are connected, you feel protected and capable of new learning, discovery, and exploration. When you experience physical or social threats, new learning is unlikely.
Ø the sense of care and connection figures predominately in our senses of wellbeing.
Ø social relationships are better predictors of well-being than economic or biological factors and serve as buffers to life’s trials. Perceiving others as social threats undermines feelings of social connection and activates the Stress Response System
Ø social support reduces both physical and social pain.
Our fourth tool in our Toolkit was Limit Screen Time
Bruce Perry, MD, Ph.D, warns us that as we navigate our way through the pandemic our Stress Response System will be chronically activated, and we will become physically and emotionally exhausted by the felt sense of threat to ourselves and our community. He reminds us that dysregulated defensive negative emotions that emerge, like the virus, are contagious and can spread within the community quickly with disastrous consequences under the stress which we have all just witnessed. The importance of Predictable, Moderate, Controllable social contexts that allow us to self-regulate and operate in a more reasonable and constructive manner are critical for our wellbeing.
Today, screen time includes not only television but social media and digital media. Screen time is a reality we all live within our current lives. It can be beneficial in many ways but there are risks involved.
The Family Digital Wellness Guide, https://cmch.tv/familydigitalwellness/ which is downloadable. Here you will find the science-based guidance for raising happy healthy children from toddlers to teenagers in today’s digital environment. Built on a bedrock of research The Family Digital Wellness Guide will give you a quick overview of your child’s stage of development and how it relates to the media they use. You can explore the guide through its interactive webpages. The guide addresses the effects of screen time on the developing brain in childhood and adolescence with practical suggestions for entering a discussion.
See our Newsletter Part IV Limit Screen Time for extensive age specific recommendations.
Ø to make screen time value laden with your values and an active collaborative decision-making process within your family or community when possible.
Ø spend time together using screen time as an opportunity to discuss how the world we share can be experienced differently.
Ø to make screen time a developmentally appropriate activity used in moderation and a part of a healthy balanced lifestyle.
Ø to use digital media to foster cohesion in the family and include Important discussions about living through COVID-19 and Digital Health.
Our fifth tool in our Toolkit was Exercise
In our previous Toolkits, we have discussed that Predictable, Moderate and Controlled environments can help us self-regulate and develop resilience. Exercise: when scheduled regularly, is mindful, creative and works for our body. It allows us to operate in a more sensible and positive manner.
“Exercise is the Best Medicine for our Brain” by Dr. John Ratey
Polyvagal Theory Explained Simply
See our Newsletter Part V Exercise for other age specific recommendations.
Ø when we provide routine and predictable structure in the home and in children’s other environments, children benefit in a lot of ways. The key, however, is to work together to find a balance between predictability and rigidity.
Ø rhythm includes singing, dancing, drumming, and most musical activities. It is present in mediation, yoga, Tia Chi, and Qi Gong, along with theater groups, walking, running, swinging, trampoline work, massage, equine grooming, and other animal-assisted therapy…even skateboarding.
Ø exercising together can effectively cultivate relationships, environments, and activities that will facilitate regulated brains and promote resilience.
Our sixth tool in our Toolkit was Sleep
Sleep is essential to our health. Sleep hygiene is especially important for adolescents because their brains want to stay up later and sleep-in later. The elderly have sleep concerns because their body chemistry and brain functioning has changed. Adequate sleep is extremely important for our brain’s health. It is not a luxury. It is something we need for our good health.
What we learned…
Ø adequate sleep allows our brains to heal, integrate the day’s experiences across many biological domains, to rest, renew, repair, and reboot.
Ø sleep allows us to store new learning and organize it to prepare for a more effective tomorrow.
Ø sleep allows our muscles and cardiovascular system to rest and reset and gives us the ability to process and integrate what we have learned in the day with our own brain’s personal history.
Ø sleep allows our bodies and brains to build resources to fight off infection and to protect us from chronic wear and tear and gives our body the ability to prepare new resources to combat infection and inflammation.
Ø sleep also can help us regulate our emotions. Adequate sleep is a healer.
THE ABCs of ZZZs. Judith Owens. MD.
A talk devoted to a detailed discussion of adolescent sleep.
Why Sleep Matters | Matthew Walker | Talks at Google
Owens, Judith, MD. Longwood Harvard series. Why Sleep Matters. The relation of inadequate sleep to motor vehicle accidents in adolescence.
[Web page] Retrieved from
Walker, Matthew, et al. (2017). The effects of sleep a sleep deprived brain.
The Sleep Deprived Brain. National Rev. Neurosis, July; 18 (7):404-418.
See our Newsletter Part VI Sleep for other age specific recommendations.
Our seventh tool in our Toolkit was Nutrition
The experience of shopping for food, helping to prepare the meal, sitting down at a common table, sharing the nutrition of both the meal and the conversation, and the company of others is sometimes one of our most cherished and nourishing memories that occurred during those shared meals. Now we are beginning to gather around the common table again thanks to the development of vaccines. Sitting at the family and community table, sharing food, conversation, companionship, and information in Predictable, mostly Moderate and Controllable ways has been foundational in our survival and thriving. However, we can no long fill our plates with random choices of food. The American diet over the past 70 years has been modified. The essential nutrients for our gut, our body and our brain necessary for survival have been taken out by processed foods.
Over the past three decades health scientists have rediscovered the importance of the relationship of what we eat to our health and to our Gut’s health and to the microorganisms that live on us and within us. They have learned the importance of the gut health and the microorganisms that live within the Guts to our body’s health and our brain’s health. They have also given a name to all the microorganisms who live in our guts and help us to stay healthy, the MICROBIOME.
The soil, the oceans, all healthy living systems are richer, healthier, and more productive the more biodiverse they are. Our guts (Gastrointestinal tract), when biodiverse and healthy are a rich and essential source of nutrients that maintain the health and integrity of our bodies, our guts and our minds. These diverse living organisms living within us and on us are central to our health.
Gupta, Sanjay, MD. (2021). Stay Sharp: Build a Better Brain at Any Age. New York, NY: Simon & Schuster
Ø we can apply Dr. Bruce Perry’s findings that when our nutritional habits are:
Predictable: planned family meals however we can manage the better
Moderate: easy prep and flexible time schedule for all members to attend
Controllable: make it a priority. Our gut health and our mental health will improve.
Ø brain growth and its development can be influenced by the food we eat.
Ø Food is a language that speaks to our genes.” Jeff Bland
Ø antibiotics in our lives and in our food have altered and shut down some of the bacteria and other microorganisms of the gut that maintain our health creating what is now called “leaky guts “that contribute to such diverse problems as inflammation, auto immune disorders, obesity, hypertension, depression, and anxiety.
Ø You can’t have good brain health without good gut health.
These past nine months have been an eye-opening experience to think about the tools in the Toolkit in a Predictable, Moderate and Controllable way and how they applied to our lives along the way and continue to guide us each day. Each of us has learned about the “Habits of Living” to relieve stress. The impact of the Pandemic locally, nationally and internationally will be with us for the foreseeable future. We, the writers, hope you have found some of the facts in the newsletters helpful. What have YOU found to be Predictable, Moderate, and Controllable to sustain you through the Pandemic? Also, please share any new thinking and/or healthy habits you may have acquired while surviving the Pandemic. We would like you to share your thoughts.