The Power of Co-Regulation

Hi, everyone. Kelly Mahler, Occupational Therapist, and I want to talk about the power of co-regulation. It is often an overlooked ‘tool’ that we can use with our clients to help them participate, engage and ultimately thrive. Many times, our clients are expected to self-regulate; to be clear on how they feel and what they need to regulate. These are unfair expectations, especially if a person has an unclear interoceptive experience!

 

What is Co-Regulation?

Co-regulation is defined by many different people in many different ways. Just for simplicity, co-regulation is what we’re all born requiring when we enter this world. We all require the assistance of someone in our world to step in and help us meet our body’s needs, to meet our regulation needs, whether it’s a nervous system regulation, or maybe it’s also to meet our survival needs, like offering us food and warmth, etc. That co-regulation process is what happens when our caregiver steps in and helps us meet our body’s needs, whether it’s for regulation or survival.

Interoception is the Bridge from Co-Regulation to Self-Regulation

That back-and-forth process with our caregiver is what co-regulation is all about. Through that interaction, we start to learn a lot about our bodies. We start to learn, for example, “Oh, this feeling, for me, might mean I’m hungry. I notice that when my caregiver feeds me, this hunger feeling goes away and my body is once again comfortable.” Through that continual co-regulation interaction with our caregivers, we learn a lot about our interoceptive system and how our body feels. We may learn what exactly a feeling means in our body, and we often then learn what we need to regulate our own body. We might even move over to a place called self-regulation.

Self-regulation is a huge buzzword. I see this thrown around a lot, especially in the schools and clinics where we have a lot of self-regulation goals. Self-regulation is all about helping a person be able to independently identify how they feel and also be able to seek out what they need in certain moments for regulation and comfort. It is important to note that self-regulation doesn’t always mean people-free. I know when I have a horrible day and I’m feeling really anxious or overwhelmed, I seek out comfort from my husband, my children, or even my dogs. I seek out that co-regulation that I need from them, but I’m independently identifying how I’m feeling and independently seeking out their support. It’s a process of self-regulation then combined with that co-regulation. But what we really need to think about as therapists is: Do we have fair expectations when it comes to regulation?

Setting Fair Regulation Expectations

I see many times that we’re immediately expecting self-regulation even when our clients are nowhere near ready for that. Maybe our clients don’t yet have that interoceptive awareness or understand the feelings in their body, or they may not be connected with those things that promote comfort in their body. In these cases, we need to rewind our expectations and offer more co-regulation. Like a lot more co-regulation!!! How can we do that? How can we offer more co-regulation?

Tips of for Co-Regulation

1. Build Mutual Relationships

First of all, a mutual, safe relationship is absolutely imperative for co-regulation. We need to establish mutual relationships with our clients. What do I mean by the word mutual? It means we are on the same level. It’s not a compliance-driven relationship where one person is in charge and the other person is forced to submit and follow demands in order to get a reinforcer. A mutual relationship is built on trust, felt safety, playing with each other during fun activities, and both wanting to be together from an intrinsic motivation standpoint. A mutual relationship is really important.

2. Be Curious & Seek to Understand

We need a lot more curiosity and less judgment when we are observing our clients. There’s a lot of compliance out there. We want to shift away from assuming that we understand a person’s inner experience. We need to stop labeling their emotions or labeling the function of their behavior (ahem superficial terms like escape/avoidance…I’m talking to you). That’s all very surface level and it presumes to understand that we know what their inner experience is. We need to shift to a place of curiosity and ask questions such as, “Oh, I see your hands are moving really fast. What’s going on, or what do you need from me?” They might not be able to answer in that moment, but shifting to a place of curiosity and no judgment can be really helpful in co-regulation.

3. Consider Your Own Interoceptive State

We know that we need to consider our own interoceptive state. Where are you at when that client starts to become dysregulated? Where is your interoceptive system at? That can be really hard. For example, when a client is starting to struggle, I know I want to help, but I start to feel a little bit dysregulated because I care so much about them, and I want them to feel comfortable and regulated. So I really have to check in with myself in those moments. I have to make sure my interoceptive system is regulated before I can be that calming, supportive, empathetic person that my client needs in that moment.

4. Focus on Internal & External Stabilization

The next consideration is to continually reflect on internal stabilization and external stabilization. These terms come from my friend, Judy Endow. Internal stabilization has to do with always considering the nervous system of the child or the adult. When a person is starting to feel dysregulated, it is not a purposeful behavior. We must think about what’s going on internally with their interoceptive system. How are they feeling? What is happening with their nervous system? We must come from a place of “what can I do to help regulate their nervous system?”

Try to think: what do I know about my client? What can I provide for regulation in that moment? Do I know that they love a warm, heavy blanket? Can I offer that to them? Do I know that they need complete silence in that moment? Maybe I need to be present without saying a single word. Remember to keep in mind what you know about the nervous system of your client and how you can offer that in periods when they need co-regulation.

Then, consider what can we do externally to stabilize? Think about the environment. Is it low? Is it slow? Can we dim the lights? Can we make the noises in the environment as quiet as possible? Really consider how we can use the environment to help stabilize their nervous system as well.

5. Co-Regulate Proactively

We know co-regulation is required when our client is becoming overwhelmed, but co-regulation is a beautiful thing to do all of the time. It is so important to be continually thinking about how we can nurture the internal stabilization and external stabilization of our clients so that we can keep their nervous system in a place where they are feeling regulated and safe.

Until next time.

To learn more about the power of co-regulation and sensory safety, register for this month’s live course where I am joined by OT Extraordinaire — Greg Santucci!

Co-Regulation & Sensory Safety: The Foundation of Successful Participation