Dr. Dan Siegel, clinical professor of psychiatry at the UCLA School of Medicine and the founding co-director of the Mindful Awareness Research Center, developed the “hand model of the brain”. This helps children and their caregivers conceptualize what happens in the brain during  dysregulation. This enhances their ability to regulate emotion. Children can be taught that there is an “upstairs brain”, represented by the four fingers folded over the thumb, and a “downstairs brain”, represented by the wrist and the palm of the hand. There is also the amygdala(and the hippocampus), represented by the thumb. Higher-level thinking, emotional regulation, forward planning, etc. occurs when the upstairs brain is in control. When our emotions control us, when we lose our temper or act autonomically, our downstairs brain is in control. The amygdala is the mechanism that senses a threat and flips control of the brain from upstairs to downstairs. We go into fight-or-flight mode or into dissociation. When this happens, Siegel says we “flip our lids”, and he uses the image of the four fingers of the hand straight up in the air to represent how the upstairs brain is no longer in control.

​This method of imagining the brain gives parents or care providers a more accurate understanding of what is driving the acting-out behavior they are seeing. It’s helpful to understand that the response required of the adult is one that helps the child “co-regulate” (more on this in another column) and bring the upstairs brain back into control. Often adults unwittingly fuel the dysregulation by acting in ways that continue to be perceived as threatening. Even telling the child to “calm down” in such a situation often causes the behavior to spiral, because it is simply adding another stressor; it is a reminder of another demand they are failing to meet. Also in a situation with a high degree of emotional charge, the adult will “flip their lid” and they will be pulled into the swirling chaos of the child’s emotional dysregulation. But with a picture in mind of what is happening in the brain, the adult can be more mindful of acting in ways that, at the very least, do not deepen the dysregulation, and at best, will help the upstairs brain regain control.

​Children who learn the hand model can use a hand-signal as a quick and easy way to signal their level of stress; they can use the four fingers of their hand to show exactly how close they are to completely “flipping their lid”. This can help begin the process of co-regulating before behavior spirals. The adult can know to support the child in practicing emotional regulation. There are many strategies, and parent and child might need to practice a number of them before they settle on effective ones. For my child, simple grounding exercises work well, in which I lead him through finding different colors in his environment as a way of bringing him back into the present. Sucking on something, either a water bottle or a lollipop is also soothing. So is cuddling with his pets. There are, of course, many different breathing exercises. Any breathing in which the abdomen is engaged in rising and falling with the intake of breath, rather than the chest, and in which the exhale is longer than the inhale, is useful in regulation. 

​It’s important to recall that trauma interferes with brain development. And the brain develops from the bottom up. Traumatized children often lack healthy development in the upstairs brain, making the imbalance of power between downstairs and upstairs much greater than in a neuro-typical child. They are not only prone to dysregulation, but any emotion can spread like wildfire in the brain. Using the hand model can be a starting point for practicing the skills that develop the upstairs brain.

Dr. Siegel has written numerous excellent books that  offer a nuanced understanding of  brain development. His hand model of the brain has become widely used by  mental health experts and schools in helping children broaden their understanding of emotional intelligence. I’ve included a helpful graphic below:


References:

https://familyandchildtherapy.com/wp-content/uploads/2019/10/Oct_hand.png

https://www.uclahealth.org/marc/

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