The Key to Self Control with OT Kelly Mahler
00:00:00 Alyssa
You're listening to Voices of Your Village, and I get to dive in with occupational therapist Kelly Mahler, all about really the key to, I would say, navigating life from a well -being standpoint. We get to chat about interoception. This is one of the sensory systems that I think is so often overlooked, and I think it's the cornerstone for mental wellness. It definitely is the cornerstone for accessing self -control. So often we want kids to control their words, control their actions, like, ask for things kindly, all that jazz, and the reality is they can't do that if they don't first have interoceptive awareness, if they aren't aware of what's happening inside their bodies. Kelly is a rad OT who works in this space. I got to pick her brain, and I am so jazzed to bring this to you because I think it also is huge for burnout and overwhelm and that exhaustion that we're often feeling in parenthood and in education. I think this is truly going to be a huge part of the conversation for so much of mental wellness in the next few years. And we get to dive into it today with you here. All right, folks, let's dive in.
00:01:23 Alyssa
Hey there, I'm Alyssa Blask Campbell. I'm a mom with a master's degree in early childhood education and co -creator of the Collaborative Emotion Processing Method. I'm here to walk alongside you through the messy, vulnerable parts of being humans raising other humans with deep thoughts and actionable tips. Let's dive in together.
00:01:45 Alyssa
Hello everyone and welcome back to Voices of Your Village. Today I get to hang out with Kelly Mahler. She has a doctorate in occupational therapy and y 'all know that I can hang out with OT's every day of my life. They're my fave. And Kelly has been an OT for 20 years. She serves school -aged children and adults. She's the winner of multiple awards, including the 2020 American Occupational Therapy Association Emerging in Innovative Practice Award. That is a mouthful. And a Mom's Choice Gold Medal. She is an adjunct faculty member at Elizabethtown College in Pennsylvania, as well as at Misericordia University in Dallas, Pennsylvania. I practiced that word a lot before we came on and I feel like I nailed it. Kelly, how do you feel like you did?
00:02:34 Kelly
You did great. It was perfect.
00:02:36 Alyssa
Oh my gosh. Thanks. I was a little sweaty. I am super jazzed to get to hang out with you because I feel like interoception is something that we don't talk a lot about that's often left off the table. And I am very curious to learn more and to dive in. And it's something we were actually at the pediatrician, Sage, my little guy was somewhere around like 18 months maybe. And I mentioned his interoceptive system and my pediatrician, whom I love, was like, what's interoception? I was like, oh yeah, okay. And gave like a little overview of what this is. And she was like, Oh, cool, I want to learn more. And I was like, alright, love it. Also, yeah, can we maybe have all of our peds know about the sensory systems? But can you break down for folks so that as we're diving into it today, let them know, like, what is interoception?
00:03:35 Kelly
Yeah, I think it's a really great place to start. And when we explain it usually does kind of like, make kind of like common sense to a lot of people, but the word interoception, it's not super sexy. It's like, so don't let it scare you away. Um, but like you said, let's say it is a sense like that we have in our bodies, all of us. And its primary job is to help us feel our inner feels. So interoception is how we might notice like a growling feeling in our stomach or our heart is pounding or our, our skin feels sweaty, or maybe we're like, you know, we're, um, our muscles feel shaky. So we feel all of these body sensations because of the sense we call interoception. And I mean, those body sensations are so important and having a clear relationship and understanding of those body sensations is what provides us with clues to a lot of what our body needs. Like it's how we know when we need to pee, it's a feeling that someone might have in their body, or it's how we know when we're, when we need to eat food, or we need to get a drink, or we're getting overheated, or it's a clue to all of our affective emotions too, like when we're getting overwhelmed or when we're excited. So interoception is a really big deal and thankfully people are starting to talk a lot more about it.
00:04:53 Alyssa
Yeah. I think it's so huge and it comes up in our work all the time because we're always chatting over here about how you can't regulate what you're not aware of. Right. And so, so often what we want, what we want from kids is like self -control. We want them to control their actions and their words and like, be frustrated, but like be kind at the same time. Right. And like all this, and the reality is like getting to self -control requires other skills. And when we often backtrack people like, okay, let's do some self -reg work. And I truly just believe we can't regulate what we're not aware of. And that starts with interoception and being able to notice what is happening inside of our body. What do I feel when it's building before I'm exploding? And that's what has drawn me to your work. I think you do a beautiful job teaching on this and breaking it down. And I think it's crucial for us doing any work in emotion processing and regulation.
00:05:52 Kelly
Yeah, I definitely agree. And I was like, I was one of those people that was, I was teaching my clients all the coping skills in the world, like take deep breaths, you know, do all this stuff. But like you said, like I didn't realize, like I had to rewind and like really check in and are they noticing their body signals or they could be noticing them and they're not linking them to the meaning. Like I had this funny feeling in my stomach but I don't know what it means. So it's like really starting all of this regulation work at the body, which is a pretty big shift, I would say in the field of emotions.
00:06:26 Alyssa
Yeah, and I think it's so important for us to have progress there. One, the reason this came up in my pediatrician is that I mentioned that Sage has a sensitive interoceptive system. Then she was curious. She was like, how do you know? How do you, whatever. And when we were, I was just doing a workshop on this, actually on the nervous system last week. And we were talking about the eight sensory systems. And when I brought up interoception, I was talking to teachers in early ed said that like, often our kids who have a sensitive interoceptive system are very aware of it, are great at potty training. They can like really feel that coming. They also can be a little bit hungry and now they're hangry. Like that can have a huge swing. And those are signs that we'll often see. And as I started to like build awareness of just getting to know Sage when he was an infant and young toddler and how his nervous system works, when those dots started to connect, it was like, oh, okay, here's what's going on here. Luckily had access to an OT that I love that helped me connect some dots, but it would be like, oh, he's a little hungry, he's melting. Like cannot do another thing, pull it together, et cetera. It was like world shattering ending. And I just like had this comparison in front of my face. My brother and sister -in -law had a baby three weeks younger than Sage. And so always as we've been like, since he's basically been in this world, say for three weeks, there's been this comparison and they couldn't be more different. And I would mention these things and they'd be like, Oh yeah, no, like we don't see that. And I'm like, cool, cool, cool. Great. So I want to chat a little bit about like, how do you kind of work with the interoceptive system, like understanding how heightened it might be for kids or not. And then how to work within what you got.
00:08:29 Kelly
Yeah. Well, I guess it's important. So first of all, I'm just going to acknowledge the fact that interoception science is relatively, I would say in its infancy compared to all of the other sensory systems, but we've learned a lot about interoception over the last 20 years. But what I'm going to say is like what we're talking about now is probably going to be shifted and changed, you know, in the next few years, it's a really exciting field to watch. But what we understand right now is that we know that we, like for every single one of us, like for you, for me, we all have like a range of how aware we are of these internal sensations. And so like for Sage, you know, that might be towards what we call like an intense inner experience where you feel your inner world in really big ways. And that might be true for specific sensations. Like he just, you know, someone could feel like hunger in a really big way and it's very dysregulating or it could be for many, many different sensations. It could be like for pain and you just like feel the tiniest little injury and it is like a big deal. And it's, and, and these kids were labeled prior to understanding, like they were labeled as the drama queen or Kings. They were, you know, they were labeled as attention seeking, which is a horrible term, but no, these are real like sensory experiences. So we have that range where you can feel your inner world intensely, but at the other end of that range, there are people that have like a muted inner experience. So they might not ever notice the feeling of hunger and they're relying on their caregivers to remind them to eat, or they might not notice sensations of pain. And like I had a client that broke his femur and walked around on a broken femur for three days before he realized--
00:10:05 Alyssa
Oh my word
00:10:05 Kelly
--he had broken it. Yeah. So there's definitely this range and we all fall somewhere in the range, but there's those extreme points too. And both of those extreme areas can lead to difficulty, you know, regulating what your body needs.
00:10:21 Alyssa
Yeah. Okay. Sick. So when I think of this, when I was like coming into this space, breaking it down with like sounds was really helpful for me or like sights, like people who, I'm a human who misses almost every visual detail ever. Okay. Literally can like walk by the pile of laundry on the stairs and they just don't see it. Or like things have to really add up visually for me to be like, okay, there's we got to clean the house at this point. And my husband is really sensitive to visual stimuli. And so for him, like, he's like, how do you not see the pile of laundry? Like, I'm like, I swear, I'm not trying to be an annoying partner. I just really don't see it. And for me, those sounds like whoooo, like, especially like clicking or tapping sounds and I married a drummer, which I love him dearly, but was like a terrible mistake from the sound perspective. Because he's always tapping on something. We have a couple of toys in the house that make noise that can make a clicking or a tapping that drive me bonkers. And I can't not hear it. And it blows my mind that everyone around me is not hearing it the way that I'm hearing it. How is that not driving you nuts? So when I was able to figure out for myself a couple of those cues, it then helped me start understand like, okay, this might be real for somebody else, right? Because at first, my experience is all that I know. And so the idea of like, okay, yeah, that person just like brushed against your body, we had a three year old in preschool, where if somebody just like, really lightly, like, went by him, he would flop on the ground. And he would say they hurt me, it hurts everywhere. And like, it was a really big deal for him. He felt it really big. And in my head was definitely like, oh my gosh, this is so dramatic. Like you got brushed, you know? And I think it's hard to have compassion when we don't feel things the same way or experience things the same way.
00:12:23 Kelly
Yeah, for sure. I mean, I think, well not I think, I know that interoception science, like that's one of my most favorite parts about it is that it is really emphasizing just how diverse each of our experiences can be in the world and we're getting better at acknowledging like that what your body feels like you're hungry is different than what my body feels like when I'm hungry. Our experiences are each equally valid. So we're getting better. I was taught as an OT to go around and label my client's emotions. It helps them understand how they're feeling, but it's just along the lines of what you're talking about. It's like we can't possibly know for 100 % what someone else is experiencing. So instead of labeling what we think it is, we're doing a better job at getting curious, and like really like setting up like a curiosity framework for kids from hopefully from day one of life as they grow about helping them understand their own unique inner world. Because there's just so much confusion that happens when someone else is labeling your experience for you or telling you how they think you should be feeling. It leads to a lot of difficulty regulating emotions. Yeah. And a lifetime often of mental health issues as an adult.
00:13:36 Alyssa
For sure. This, it reminds me. So in our phases of emotion processing and the method that Lauren, my colleague and I co -created, we researched, it, phase two is recognizing the perceived emotion, right? And that there are different ways to be able to acknowledge like that. This is what we're perceiving. This is my understanding of this. And then as they get older, being able to ask the right question so that they can give us information and what leads up to this. But I was just recently at a school where they were talking about this idea with kids of like, is it a small problem or a big problem? And I was like, Oh, I, I hate that. I hate it so much. And I was just thinking of like, man, I, if I'd like had a really long day at work and like teaching, whatever. And then I'm going home and I'm on my way and it's just like fried and I'm done. And I get out to my car and my keys are locked in my car. Right? Like, is this a big problem in the grand scheme of things? Like, no, but is that helpful at all? If somebody came out in that moment was like, Alyssa, is this a big problem or a small problem? I would probably want throat punch them. Like what-- that is zero percent helpful. So like that just came up for me of like the labeling in this like our desire to be like this isn't a big deal.
00:15:01 Kelly
So invalidating. I would love to run through every school in our country or just the world really that has the 'size of the problem' poster and just rip them all down. Like it is so invalidating to someone else's experience. And I'm just going to say, though, in case anyone out there listening is like, Oh my goodness. Like I have that poster. Like I used a similar strategy. Like when I was first in OT 20 years ago and it was called 'big deal versus little deal'. And so I was doing that like, and you know, I think it's important that we just grow and update ourselves and keep it.
00:15:35 Alyssa
Yeah. You can rip your own poster down. Yeah. Well, if in 10 years you're doing things the exact same way you're doing them now, like we're not growing and that isn't progress. And I think so much of just being alive is being like, oh, I learned something new and here's how I'm gonna apply that and then bring that into this. But I think when we're looking at interoception, what I'm curious about is like, are there ways if we have someone like the femur human who's like walking around on a broken femur for three days, are there ways to build greater awareness of interceptive cues?
00:16:16 Kelly
Yeah, absolutely. Like interoception is highly changeable. It's highly changeable, which is really exciting. There's lots of research supporting that interoception growth can happen in most humans. And so it's a really exciting field to be a part of. And I would say, well, I don't like to throw this term around loosely because sometimes it shuts people down. But the science, like what they're using in these studies to change a person's interoception and help it help a person grow is something called body mindfulness, but don't panic. Like when I read that, I'm like, Oh, here we go. Like, it's just going to be like super, like, you know, like kind of cheesy, but, um, I know mindfulness has a lot of really good science behind it, but it just has this like, also yeah. But really all it is about is just helping people to connect with their bodies um, more frequently notice how their body's feeling and be curious about it and develop that understanding of like, what do these feelings in my body mean for me? Um, so that's really the heart of interoception work and like helping our young ones all the way, like where there's adults that are, you know, really having their own interoception journeys right now. And myself included, like when I first learned about interoception and started doing my own work, like I realized like I was really disconnected from my body. Um, and, you know, we, we kind of live in a society that, that encourages us to ignore our bodies, you know, to be busy, to be on our screens, to, even if we look, if, if we notice something in our body, we get messages like, Oh, like, don't listen to your body. It's weak. You know, don't take a break. That's for the weak people. You know, you work yourself till you have a chronic health condition, you know, it's just like all this messaging that we receive. So, yeah, this body mindfulness is really helping a lot of people to reconnect to their bodies or connect. And we've, what I've done as an OT is adapted a lot of that mindfulness because it was so abstract for a lot of my like little clients and even some of my adult clients, it's really abstract work.
00:18:22 Alyssa
Can you give me an example of what like building that awareness might look like in practice?
00:18:27 Kelly
Yeah. So one of my favorite things, um, like ideas to give families, um, is to just take your daily routine and find times in that daily routine that might be evoking a stronger sensation in your body or your child's body in a fun, like in a, when they're regulated, when they're in a good thinking place. And so for example, like when they're washing their hands, they could be having like, maybe a stronger sensation in their hands from the water. And you could say like, I wonder how your hands feel right now while you're washing them. Or maybe, you know, you're playing on a playground and you're running around and just inviting them to notice like, how does your heart feel right now after running? So just not doing anything extra in your day, just finding those moments that your body might be experiencing a stronger sensation, which helps to capture attention. And so that's why we're working in those moments where we're trying to capture those bigger sensations, but not during a meltdown sensation, but like, you know, when someone's regulated, they're playing, they're in a good spot and we're just inviting them to notice how their body is feeling.
00:19:34 Alyssa
Yeah. Okay. Sick. So for Sage, one of the things that we did was talk about his heart a lot. Right. And we would say, I did it to myself first, like where I would say, Oh my goodness, my heart is beating so fast. I'm so excited that we're going to whatever, or I am feeling so frustrated that we were just build, I was building this block tower and it crashed. And I feel my heart beating so fast and like started to draw it in first to myself. And then we would then bring it back to him. And I was like, oh, I wonder how your heart feels right now. And we would also do it when he was calm, not just like when he was excited or when he was nervous or whatever. And just to start to notice, I think it was cute. There was like one moment where he was crying, he was having a hard time and he said, mama, I can't slow my heart down. And I was like, yeah, buddy, I've been there. I got you, boo. And that like popped in for some co -regulation, but it was like, that was his cue for himself. Like, I can't slow my heart down. My heart is beating fast and it's not slowing down. When I, for myself, started, like, just tuning in, this podcast, these listeners are not new to the fact that the word mindfulness for me for a long time was really triggering. And so I, yeah, that was like, so on brand there, I would pop in, usually the word awareness was like, easier for me, like, I was building awareness, I'm noticing those are like my two words that feel better for me. And, um, and my co -creator of the CEP method, Lauren, like works in the mindfulness space and it's just like, so we, we're very different experiences of that word. Um,
00:21:15 Kelly
I didn't know any of that backstory so I totally get you on that
00:21:17 Alyssa
It was so perfect. When you mentioned it, I was like, Oh, I love her. But so for me, when I was starting this, one of the things that I did was just set a series of like random timers on my phone that when I was teaching would just like go off. And the only goal in that moment was not to change anything, just to notice, like when that timer goes off, notice, like, what's happening, what's happening for my heart, where are my shoulders, what's my breath like? And just to start to like kind of have this practice of building awareness, because I found it hard to like, remember, I don't know if that sounds silly, but like, I'd get to the end of the day, and I'm like, oh, yeah, I didn't do any of that today, like didn't remember to notice, you know? And so for me, I needed like a little trigger almost to like then be like, all right, my timer went off, I'm just gonna notice. And the more I did this and the more I practiced it, the easier it became and now can do it without timers where I can tune in and notice, but I needed something to like kickstart me.
00:22:20 Kelly
Yeah, I love your idea about timers. Sometimes we'll invite people to like pick one activity that they do every day. So like, maybe it's like putting on your shoes to go out the door and then, um, take time to notice a certain body part. So like, how do your hands feel like, or how does your heart feel or how's your stomach feel or how, you know, how did your nose feel right now? Like we break the work down into one body part at a time at first, and then build up to hopefully giving someone the concept of how does my entire body feel, but we found by chunking it into like one body part at a time. And like you said, like finding a routine in your day, like when are you going to tune and notice how this body part feels can be really helpful because we're not, we're not like encouraged. Like this is not something that many of us are like, you know, in the routine of doing, I would say. I think, you know, it's getting better. Like bodies are being talked about more.
00:23:11 Alyssa
Sure.
00:23:11 Kelly
Be in your body, but I think we have a long way to go.
00:23:15 Alyssa
Totally. And just like culturally, I mean, yeah, it just gets pushed to the back burner. I am curious about your thoughts on the role that interoception plays in anxiety. I have my own thoughts and I want to dance here a little bit. Yeah, I'm just going to, I'm curious if you want to share any thoughts there.
00:23:38 Kelly
Yeah, I think that interoception and anxiety are closely related. I don't think we understand a hundred percent. There's a lot of studies that show that people that, you know, have anxiety or anxiety disorders tend to be more towards that intense inner experience side of things. Like they feel a lot going on. That's a tends to be kind of where I live, but I also know that I've had a ton of clients that were towards the muted side of things. And they still also had equal difficulty, you know, regulating their emotions. Cause they weren't getting reliable information from their body, like when they were starting to get anxious and then their anxiety was like a surprise to them. Um, it falls in both, like, you know, if you could have a muted experience or an intense, but it just comes back to those body sensations and how reliable are they? And can you shift your attention away from a really intense, like for someone with panic disorder, if they are, you know, experiencing whatever, um, is that intense sensation for them, whether it's like maybe a racing heart or breathlessness, you know, that sensation just completely trumps their entire attentional system, right? And they can't shift away from that interoceptive body signal, which of course leads to, you know, to the panic. So there's a lot of connections. I think we are still learning what they are, but definitely interoception has to be a part of, if someone is dealing with anxiety, it has to be part of the process for them.
00:25:06 Alyssa
Yeah. When we, in our book, we separate sensory versus emotional regulation and the sensory part being that like interoceptive piece, a lot of the time comes into play here when we're talking about anxiety of like, what does it look like to notice when this is building and what that physiological experience of whatever the trigger was is and being able to then regulate and get back into a body that's feeling safe and a brain that feels safe and be able to move through fear then, right? Without that spiral into anxiety where we are kind of like stuck in the physiological part of this. And I think interoception and interoceptive awareness is, I think what we're going to see as like a front runner in how to navigate anxiety in terms of like, I'm thinking of the Yale study that came out in 2019 that looked at anxiety in kids. And one of the big things that came out of it was really teaching kids how to be in fear without getting into a space every time where they were in distress. So how can you experience dysregulation and notice it and build awareness of it and regulate without getting into distress? And like for me, interoception plays such a huge role there because we have to be able to notice what is it feeling like, and how is it adding up before we go into the emotion processing work of like what triggered it and what's happening outside of that. But just the ability to regulate the nervous system is going to start with the awareness of what does it feel like when I'm starting to get dysregulated?
00:26:59 Kelly
Yeah, absolutely. Well, and I think too, um, it goes, it goes beyond that as well. Like it also, interoception is how we come to learn how to adjust the way our body feels, like noticing when we're comfortable and uncomfortable and being empowered to change the way our body feels if we feel uncomfortable. And so if you're completely, if you have like an unclear relationship with your body, you're going to have a really hard time feeling like you have autonomy and control over the way your body feels. So I would think that, that's such an interesting study you were talking about the Yale study and I'm wondering would the interoceptive awareness piece be a key player in children that can, that can kind of sit in fear without getting distressed because they know that for most days that they have this autonomy and understanding about their body. It was just, it's just a curiosity that came to my mind when you were talking about that study. It's really interesting.
00:27:55 Alyssa
Yeah. It's so interesting to me. And I just think like, you know, you know, anxiety is high in kids and it's obviously like in the forefront and being talked about and how do we navigate it? And I think that interoception as this unfolds is going to play a greater and greater role in that discussion. We were just having a talk about this on our team and the idea of like interoception shaping our wellbeing. What are your thoughts?
00:28:24 Kelly
Yeah, that's what my whole career.
00:28:25 Alyssa
Yes. Just yes.
00:28:26 Kelly
That would be a yes.
00:28:34 Alyssa
Yeah, I mean, I agree so much, like, because for me, interoception so much of this is that awareness that we, as you stated a couple times here, like, we've gotten away from or isn't a part of our cultural experience in the day to day. And it is the cornerstone for how we move through the world.
00:28:55 Kelly
Absolutely.
00:28:56 Alyssa
Right, that like so many of us are just in this subconscious, just really operating from like habit. And so then it does feel like things are happening to us.
00:29:08 Kelly
Yes, and we have very little control over it.
00:29:11 Alyssa
Yeah, yeah. And I've been thinking about this in the like idea of like burnout and exhaustion and how we can like shift that narrative, that experience really, when we can build more awareness for ourselves internally of like, what do I need to feel good? And how do I notice when I'm not before I'm drowning?
00:29:39 Kelly
Yeah. I mean, it's definitely involved in being able to set healthy boundaries for yourself.
00:29:45 Alyssa
Yeah. Yeah.
00:29:47 Kelly
I'm a work in progress on that.
00:29:49 Alyssa
Same. Same. Well, and then, cause of course, also the narratives and parts of us are going to pop up that are like, oh, but I'm supposed to be able to power through. I'm supposed to be able to do X, Y, and Z or yada, yada. And so much of that's cultural, but we can't do the, even what boundaries do I need for myself in a dream world without the awareness of what's my just experience here?
00:30:12 Kelly
Yeah. Yep. You have to understand yourself first before you know what boundaries you need to thrive.
00:30:17 Alyssa
Correct. Yeah. And I think for so many of us, it just like, from the moment we wake up, there is this like disconnection from our body that then we just hit a place where we are at a breaking point where it's like, I need a break to recharge. And that break better really recharge me because I was so depleted. And then I come back in and just like, again, work towards depletion to the need a break that's gonna sustain me again for another chunk of time. And I really think that like interoception and being able to notice just those small things that really add up for us, like the sounds in my household, right? That the being a sound sensitive human for me is so connected with interceptive awareness just to even know like I'm a sound sensitive human.
00:31:08 Kelly
Yeah, you have to be aware of how sounds and which sounds are causing a certain sensation in your body.
00:31:15 Alyssa
Right, right. And so, and without that, then I, otherwise it would just be like, oh yeah, that Thomas the train toy is just clicking in the corner and I then snap at my husband or my kid. And it's really because this sound has been clicking in the corner for a while. And in the background, it's just adding up for me. And I'm having a reaction to it, right? But without the awareness of that, I just end up then in that cycle of like snap, repeat, snap, repeat. Versus like, oh, I need to take a break from Thomas. You know, like--
00:31:49 Kelly
We all need some breaks from Thomas.
00:31:51 Alyssa
Right?
00:31:52 Kelly
But you're so right. You need that interceptive awareness to put all those, all of that together for yourself.
00:32:00 Alyssa
Yeah. And I think it's just so huge in that, like feeling of burnout or overwhelm or exhaustion. And we talk about this a lot in parenthood because there's so much stimuli and it's constant. And then we're also, we have the mental load and all that and everything adding up and and being able to, I think, look at what do we, what does self -care look like for me? And not in the like, I'm gonna go out to dinner with friends or I'm gonna get a mani -pedi, like, cool, cheers. But I'm more interested in the like self -care part of what boundaries can I set for myself around, you know what, my body needs a break right now. I would love to read that book to you. I will sit next to you instead of having you in my lap sort of thing, or that I need a break from Thomas. What, but being able to take care of ourselves all day requires this awareness.
00:33:00 Kelly
Absolutely. But I think when you say it out loud, you know, to your child, like what amazing modeling you're demonstrating from the time they're little. Yeah, it's really powerful.
00:33:13 Alyssa
Well, I'm so grateful for your work because truly, I agree that it shapes our wellbeing and that we aren't gonna be able to move through and get to things like self -regulation and frankly, even self -care until we have a greater understanding of interoception for ourselves, with our kids, and being able to see where we fall in those things. I wanna give you a hot scenario before we leave that has come up a lot for us, and it's around like toilet learning. If you have a kid who is on that femur end of the spectrum, broken femur person. Thank you for that anecdote, because now that's what that end of the spectrum is going to be called for me. The femur end of the spectrum. If you have a kid who's on that end of the spectrum and really isn't noticing those cues of like, I have to go pee. How do you support that?
00:34:06 Kelly
Yeah, well, there's a lot of hope in that space. This is probably our most frequently asked question is interoception and toileting. So--
00:34:14 Alyssa
Yeah we get it a lot too
00:34:17 Kelly
Yeah, but I would, well, we do not ever start going right for like bladder potty part sensations. Like you want to start at like more neutral body parts. Like I said, like we chunk this work and helping the kids or the adults connect to one body part at a time. So you can still work on like toileting type sensations with hands in play. Like you can invite the child to notice like when their hands might feel messy or clean or wet or dry or tight or loose. Like those are all important sensations eventually when you get to more of the potty part signals. And so we just really help them to slowly connect to their bodies. And eventually over time, if they have a caregiver, like a parent that's willing to get in the bathroom with them, the caregiver, first of all, like you said, we invite them to start talking out loud about the way their bodies are feeling in relation to everything outside of toileting. And then we're going to move toward towards toileting, but then also getting in that bathroom and inviting the child to like, notice what sensations they're having, you know, when they're sitting on the, on the toilet, or when maybe if they're releasing a stream of urine, what they feel, can they stop that stream of urine for a second? How does that feel? Like just really getting in there and helping them connect and be patient because it can take, Um, for some people can take a while for them to start noticing the clues from their body, but it's so much more of an affirming process than behavior -based. Those behavior -based systems can cause, I could go on for another hour about the issues with behavior -based systems, but it can lead to a lot of difficulty with toiling long -term, a lot of shame can pop up there. Um, and so I think just getting in there and using an interoception approach and thinking about too, the child's world and is there, is their world, um, quiet enough for them to be able to shift their attention away from the outside world and notice their body. Like so for you, I probably wouldn't want to be doing toileting while Thomas the train is clicking in the corner of the room because your attention is just naturally pulled to that out of survival for your nervous system. Right? So you have to think even before you invite the noticing, that body curiosity, does the child feel safe right now? Are they regulated in their body? Do they want to pay attention to how their body is feeling? And can they shift their attention away from the environment? Is that environment safe enough for them to be able to notice?
00:36:50 Alyssa
I love that note. And I think one of the, for me, I mean, behavior, it can lead to so many other things down the road if you're doing behavior -based, but also it's just a bandaid on a bullet hole. And I'm a human that wants to use my time and energy as efficiently as possible, right? And so whenever I'm looking at like, Oh, I'm just trying to get a different behavior to happen. And I'm on that behavior surface. What it usually means for me is like, I'm going to end up spending this time again and again with different behaviors until I figure out what's really driving the behavior. And so like selfishly, I don't want to do that. I don't want just like another behavior to pop up because the same root of the challenge hasn't been addressed. So when we're looking at, I love that, the like hot tips of focusing on other body parts and really like how effective that is, not just for toileting, but that that's gonna play a role then in so many other things that like, when you are supporting kids with tools for regulation, if they have an increased body awareness now, that's gonna be easier too, right? That you're really paying it forward for so many things, not just toileting. And if we do a behavior -based approach to toileting, first of all, it's probably gonna backfire at some point, like we're gonna see regressions and all that jazz because they still probably don't have that body awareness component down, but also you're only tackling toileting. Whereas with this, when you're building this awareness and really getting to the root of this, it's gonna affect so many other things. I love that. Love efficient time and energy spent. Love it. For me, it makes it easier to like, do things that are the long -term. Like if it's a long game, I'm like, okay, but if it's gonna be X amount of like hours or this amount of time and energy spent now, but then there's this payoff of what this looks like and the skills they have or what they have access to or whatever, like that's worth it for me. Uh, I need to know that like, this is worth it for me in order to commit to something often. And that's one of those. Sick. Awesome. Kelly, where can people find you learn more about your work and you and all this rad stuff you're doing?
00:39:18 Kelly
Probably my website would be the easiest way to find me and that's, kelly-mahler.com. We have lots of free resources on there and on the links to all of our social media accounts. If you're someone that likes to follow.
00:39:32 Alyssa
Sweet, we will link all of that in the blog post and it's Mahler, M -A -H -L -E -R. But we'll link all of it in the blog posts in the show notes for this episode. And we'll tag Kelly over on Instagram when we share as well so that you can easily find her and her work. I think it's so darn helpful. Kelly, thank you for hanging out with me.
00:39:54 Kelly
Thank you so much for having me. This was a fun chat.
00:40:00 Alyssa
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