Frankie (A story about challenges with emotional regulation)

byJoshua Metz, LCSW

During the August 2011 Family Compass Preschool Alliance Training for teachers, Dr. Moshe Shtuhl and I presented a case study dealing with emotional regulation. Emotional regulation is the ability to remain calm and organized in order to interact with others and participate in whatever is going on. It’s the skill of keeping it together well enough when you’re really excited-frustrated-sad-angry in order to keep playing or doing. And when things get exciting or challenging, or even a little scary, it’s the ability to respond in a way that keeps you moving forward.

The following story is adapted from that presentation and I bring it here because it might teach us a thing or two about other emotionally sensitive kids we might know, and about the quest of helping them feel better.

This is a story about Frankie, a sweet, loving 4-year-old girl with long hair and freckles. Frankie is having a lot of trouble at her preschool, Dandelion Pride. One sunny Saturday morning, Frankie’s Dad, Paul, is catching up with his friend, Jonah, at a local coffee shop. Jonah knows that something is going on with his friend’s daughter, Frankie. Paul had talked about it with Jonah a couple of months ago. It’s been a while since Paul has been able to give his friend an update on everything that’s been going on. And a lot has been going on!

When Paul and Jonah sit down at a table near the windows with their coffee, Jonah asks Paul how things have been going with his daughter, Frankie. Paul is excited to share all the things that have been happening, so he starts right in on something that happened the other day. Jonah stops him with a wave of his hand, “Hold on, Paul. I want to hear about everything, but first remind me of how it all got started. Like just the Cliff Notes, please”.

Paul lays down his iPad, takes a sip of coffee, and begins. “You know that Frankie has always been on the sensitive side, right?”

Jonah nods, settling back in his chair. He knows that when Paul has something important to say, he doesn’t go light on details.

“She’s always been easily excitable and can cry at the drop of a hat,” Paul continues. “Wanda and I just thought we were raising a sensitive soul. We didn’t think anything was really the matter or that we needed to do anything. Her preschool teacher, Mrs. Magonical, caught me one day during pickup and asked if we could have a conference to talk about Frankie. She said that she wanted my advice about some things that were happening and to see if I could help. I love that about Dandelion Pride.”

“Yeah, you guys are always raving about that place,” Jonah interjects.

“Well, you know, they treat us like we’re part of the team. So anyway, we had the conference, and this is the picture that they painted.” Paul pauses and looks down at his iPad, sweeping and tapping his fingers on the screen. “Hold on a sec. You know how organized I am. Well, I kept a list of the things that we discussed during that meeting. ”

“Tell me about it,” Jonah replies.

Paul smile and looks up at his friend, “Ok, here it is. This is what she told us. Ready?”

“Uh, I think so,” Jonah say, frowning. What could be wrong with such a sweet girl that his friend needs to keep a list? Jonah leans forward.

Paul starts to read off a list of behaviors and descriptions that Frankie’s teacher, Mrs. Magonical, observed during different activities at preschool. “Frankie is having a tantrum at least once a day that requires a teacher or aide to intervene and help her calm down. Frankie would cry, tear up work that she is doing, and may even throw objects in frustration. It’s not aggressive, but she would get pretty worked up. You’ve seen this before.”

Jonah nods, remember a children’s birthday party at a neighbor’s house. Frankie’s balloon got loose, and Paul and Frankie ended up missing half the party because she just couldn’t recover.

“Mrs. Magonical said that there were clear reasons for the meltdowns, but there didn’t seem to be a consistent pattern that they could identify. It’s like most anything would set her off — a mistake in her work, a change in schedule, an innocent altercation with a peer during line-up for the sink.”

Paul paused fro a moment, flipping between pages with a swipe of his finger across the touchpad screen.

“It says here that they said that Frankie appeared to be more anxious than the other kids about the daily schedule, and will always want to know what the schedule is for the day once she arrives. We see this at home a lot, too. I always thought she got it from her mother. But at school, if there is a change in schedule, she will want to know all the details – especially why. This questioning of the schedule change can last for a few weeks, even if the schedule change was a one time occurrence.”

Jonah leans forward, putting his coffee down, “Wow. Poor thing”.

“Yeah. You know that nickname we have for her?”

“Yeah, ‘Frankie Two Times’.”

“That’s it, Frankie Two-Times. You ask her to do something, and her first response is always “No thank you”. You ask her again, and more than likely she say yes. It drives us crazy sometimes! Well, Mrs. Magonical described the same behavior at school, only the second response was becoming more and more negative. They were worried that she was shying away from activities, and it was becoming a habit. They didn’t push it, because they didn’t want to upset her. But if she isn’t doing what she’s supposed to in school, then what could she be getting out of it? And we were worried about this negative trend.”

Paul paused to sip his coffee, once again letting his finger dance across the screen. “Lets, see. What else did they say? Oh. A couple of times they had movie day, but Frankie would have none of it. For one movie, she wouldn’t even stay in the room. She sat and colored in the Director’s office. Wanda and I talked about this, and we realized that she was doing the same thing at home. And remember I told you about taking her to the movies? We had to leave after ten minutes. And it was a Disney movie, for crying out loud!

Paul puts down the iPad and sits back in his chair, letting out a long breath. Jonah matches him, sitting back in his chair. He places his hands on his head, saying “Wow! That’s a lot, Paul. I had no idea. What did Wanda and you think?”

Paul replies that all this was hard to hear, but it wasn’t a surprise. “But Mrs. Magonical also talked about what a great kid Frankie is. Her laugh can be infectious. She’s sensitive and seems really empathetic to the other kids. And she really tries to please. And when she is calm and happy and not melting down, she is a pure delight.” Paul paused, looking about the window. “I might be embellishing a little, but the point is it wasn’t all about what’s wrong, there was lots of what’s right, too. Basically, they painted a picture of our whole child.”

“So what happened next?” Jonah asked, “Wasn’t this conference a couple of months ago?”

Paul responds that Mrs. Magonical said that she wanted to have another meeting with the preschool director, Paul, and his wife, Wanda, to talk about a how they could put a plan together. “They said had some ideas that they wanted to try. They also wanted to hear what we do at home and if there were some tricks or approaches we had that we would share with them.”

“Sounds good.”

“Well, we had the meeting. And the upshot is that we decided with the school to consult a therapist about her anxiety.”

Jonah seems a little surprised. “Really? Is it that serious?”

Paul responded that it was hard to hear at first. But as he and Wanda talked with the school and with each other at home, they realized that the stuff the school was seeing was similar to what happens at home, and that it might be helpful to have some objective eyeballs take a look and see there were some additional ideas about what was going on and what they could do about it. “So we made an appointment, and have been working with the therapist and the school for the past month or so, and I think it’s really paying off. ”

“So what is it? Does Frankie sit with the therapist? How does it work?”

Paul says, “Well, it’s more like working with the school and us to come up with a picture of what’s going on and try to find some specific strategies that they can do at school and we can do at home.”

“Like what?” Jonah askes.

“We really started to ramp up the play dates with Frankie, especially with a girl that her teacher at Dandelion Pride said Frankie really liked. Frankie does a lot better when it’s just one kid, or maybe two. It’s when there’s a group of kids that can trigger a freak-out, or her running inside. We’re trying to do one after school during the week and one on the weekend. Frankie loves it.”

“Play-date therapy, I love it!” Jonah chuckles.

“The therapist helped us find things that help Frankie calm down, like reading a book. So now we’re encouraging her to read books if things are too much or she needs a break, which always seems to calm her down. They offer it at school too, when she starts to get upset and they see that she might need a break. They’re really awesome about accommodating this.”

“So, what? Is she on a different schedule? How do the other kids react?” Jonah remembers his own experience at school, when he had to wear a huge caste on his leg after a bad fall at camp. He had to use a special desk that folded up and down. Everyone wanted one, and the teacher almost had a rebellion on her hands before she showed them that I couldn’t fit into my desk with the caste. Jonah smiles, remembering his friend Jack saying that he wished he had a broken leg, minus the itching and throbbing pain, of course!

“I’m not sure. It doesn’t seem to be a big deal. You know, I’ve been having a weekly check in call with her teacher, just to touch base on how things are going and if there is anything we need to share. The Therapist echoed that it’s important for school and home to be in synch about what’s working.”

“I guess if it helps, it’s no big deal.”

“We also started practicing a specific way to help Frankie calm down. The therapist calls it progressive relaxation.” Paul demonstrates while describing how Wanda and he taught Frankie to take three deep breaths while clutching a stuffed bunny. She then clenches and unclenches her hands, then her feet.

“Okay,” Jonah replies skeptically.

Paul continues, “It helps the body calm and down, and that helps reduce anxiety. We’ve started to do this every morning when she sits down to breakfast and every night before she goes to bed. At school, they’re trying to encourage Frankie to do this before big activities or when she needs a break.”

“Isn’t she a little young for this?”

Paul laughs. “No, but it really seems to help. She even says that she feels better. She says she needs to fill up with the “Calmies”. ”

Paul pauses as waitress comes over to refill the coffees and clears away empty half-and-half containers. Paul grabs for a the sugar, saying “We kept an eye out for things that might trigger her anxiety – – Loud, noisy, busy places, and” Paul hesitates, lowering his voice, “and Wanda me fighting.”

“Come on. You guys are great!” Jonah says, shaking his head.

“I know. But we can get pretty loud when we argue. You know, it’s funny. As Wanda and I talked more about what the causes could be, we realized that Frankie really doesn’t like conflict. So you can imagine what she was thinking when Mom and Dad go at it! So we’re really trying to keep our arguments out of earshot. It’s crazy, but I think it’s bringing us closer. We almost feel silly hitting the pause button on the argument in order to go into another room.”

“Nice.”

“Oh, you’re gonna love this one, Mr. Netflix. We’ve started watching movies with Frankie. But not like we used to, where we would just throw it on for Frankie and then bury ourselves in the iPad. Now we’re actually watching it and talking with Frankie about it. Like why the wicked stepmother is so mean to the Cinderella, or what we would do if we were fairies and we had to save the fairy kingdom.

“So, let me get this straight. TV therapy? Hello, Dr. Phil! I love it!” Both men start laughing.

“Kind of. But seriously, I guess the idea is to help Frankie talk about some of the big emotional themes in the story and help her think through what they mean. I think they call it ‘Name it to Tame it,’ or something. You talk about being scared so the feeling isn’t so scary any more. I don’t know. What I do know is that she really likes it, and so do Wanda and I. and all these Disney movies have the same theme built in…something scary happens, somebody does something, and they all live happily ever after. It teaches Frankie that when something is scary and you do something about it, it’s not so scary anymore.”

“I never thought of it that way. Those folks at Disney!”

“And the more we talked about what was going on the movies, Wanda and I started to get a better sense of what types of things scare Frankie. So Wanda had the great idea to make a list of the things that scare Frankie, and they talked about them. The Therapist said that this really helps with Frankie’s Emotional Thinking.”

“Like what?”

“Like putting her clothes in the hamper in her bathroom. She would never do it. When we pressed, guess what? Freak-out! Well, we put that on the list, and we learned that Frankie was scared that something would come out and grab her. We talked about more, and Frankie came up with a good solution herself. You know those Dream Catchers that they make in camp? With string and sticks? Well, she made a laundry monster catcher and we put it in the bottom of the basket. And guess who now looks forward to putting her clothes in the basket?”

“What a smart girl!”

“And you know how I said that she was having trouble with changes in the schedule, and how she always wants to know what’s going on?”

“Yeah. So how did you fix that?”

“We didn’t fix it. We saw it as a strength. She’s a planner. The therapist talks about sequencing or motor something. Anyway, every morning we go through the daily schedule, but with a focus on what might be different. The same thing happens at school. And it’s so cute. She got one of those day planners at the bookstore and she pretends to write down her schedule each day. Sometimes she draws pictures of the things that will happen that day. ”

“You gotta get her an iPad, App-Dude”.

“Tell Wanda that!”

“I will. So you guys are all over this. She’s a lucky girl.”

“Well, what would we do if she broke her leg or caught a virus. To us it’s the same thing, only on the inside. We’re also really trying not to freak-out ourselves and over-react when she is having a hard time. Before, we would get as anxious as Frankie, and that could send her spiraling up and make the tantrum even worse. ”

“She would feed off it,” Jonah said.

“Exactly! Now, we do what I call “freeze and frame”. When Frankie starts getting upset about something, I will literally stop in my tracks for a second. I will then try to frame the situation, like ‘You don’t like that loud noise’, or ‘You really wanted to make that picture perfect, and now there’s a mistake’. It’s like all she wanted was to be understood.

“Don’t we all!”

“Yeah, tell me about it. Her teacher has been great about doing this too. You know, I don’t know what we would have done if we didn’t have Mrs. Magonical and the other folks at Dandelion Pride. I love that place.”

“So you keep saying”

“I know, broken record. Well, they’re a big part of what’s going right. ”

Paul’s phone vibrates. He takes it out and frowns.

“Oh, crud. I gotta run. I’m reading in Frankie’s class today. Thanks for listening, pal.” Paul gets up, grabbing his jacket from the chair next to him.

“Any time, friend. Listen, I got this one today. I’ll give you call this week,” Paul says, smiling at his friend.

The two friends shake hands. Paul hurries out the door, while Jonah picks up a newspaper and settles into another cup of coffee.

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