What happens when we understand and harness our cognitive strengths and weaknesses? Join us as we unravel the transformative impact of integrating self-regulation and executive function skills in educational settings, highlighting a primary school in East London. We promise you'll deeply appreciate the biopsychosocial model and see how biological, psychological, and social lenses can illuminate behaviour in both students and colleagues. Plus, we explore these concepts in the realm of midwifery, providing insights into the experiences of mothers and neurodiverse midwives.
Ever wondered how the brain adapts to change? We share compelling stories and scientific insights on cognitive flexibility and neuroplasticity, which are vital for problem-solving and adapting to unexpected challenges. Learn from historical cases like Phineas Gage to modern imaging techniques, discovering how our understanding of the brain's capacity for change has evolved, emphasizing the balance between rigidity and chaos. This segment is particularly resonant for those navigating the complexities of childbirth and early parenting, where cognitive flexibility can be a game-changer.
Finally, we tackle the nuanced relationship between hormones, ADHD, and executive function in women, particularly during pivotal phases like the premenstrual cycle and postnatal period. Hear about the emotional regulation challenges that mothers face, including the compelling interplay between the prefrontal cortex and limbic system during high-stress situations. We'll also discuss the significance of compassionate communication and empathy in healthcare, and the power of empathetic support within diverse workplaces. Join us for a conversation that is as enlightening as it is compassionate, featuring the invaluable insights of our guest, Belinda Edlington.
Outro
This is a special edition episode recorded from a webinar.
What happens when we understand and harness our cognitive strengths and weaknesses? Join us as we unravel the transformative impact of integrating self-regulation and executive function skills in educational settings, highlighting a primary school in East London. We promise you'll deeply appreciate the biopsychosocial model and see how biological, psychological, and social lenses can illuminate behaviour in both students and colleagues. Plus, we explore these concepts in the realm of midwifery, providing insights into the experiences of mothers and neurodiverse midwives.
Ever wondered how the brain adapts to change? We share compelling stories and scientific insights on cognitive flexibility and neuroplasticity, which are vital for problem-solving and adapting to unexpected challenges. Learn from historical cases like Phineas Gage to modern imaging techniques, discovering how our understanding of the brain's capacity for change has evolved, emphasizing the balance between rigidity and chaos. This segment is particularly resonant for those navigating the complexities of childbirth and early parenting, where cognitive flexibility can be a game-changer.
Finally, we tackle the nuanced relationship between hormones, ADHD, and executive function in women, particularly during pivotal phases like the premenstrual cycle and postnatal period. Hear about the emotional regulation challenges that mothers face, including the compelling interplay between the prefrontal cortex and limbic system during high-stress situations. We'll also discuss the significance of compassionate communication and empathy in healthcare, and the power of empathetic support within diverse workplaces. Join us for a conversation that is as enlightening as it is compassionate, featuring the invaluable insights of our guest, Belinda Edlington.
Outro
This is a special edition episode recorded from a webinar.
Have I tried to join your group?
Speaker 2:I'm not sure I got through yet Well, it's like me I do as a co-host Evening.
Speaker 1:Well, I'm glad you're as a co-host, Laura. It's my Zoom, eh.
Speaker 2:Well, I've got Facebook Live as well, so I guess we'll be everywhere.
Speaker 1:So I've joined it through my Zoom thing, but it's linked through to your thing, so you do whatever you do on Facebook.
Speaker 2:Yeah, well, aye, I think so we can, whatever we can, share the video. Honestly, technology and me are just not gelled together very well at all. I think there is somebody. Katie McHale is watching. Hi, katie, god, my grey hairs, I think the sun, I've got a little Cruella stripe going on here. Anyway, so you've just come back from some training. It's been a long day for you, belinda.
Speaker 1:Yeah, it's really exciting. It's working with a primary school in East London and they are really thinking about self-regulation and executive function skills and how to build that in the classroom and basically sort of using a coaching approach both with the children within the staff building into the classroom and so like, what kind of like, what kind of stuff is, how do you start off that training?
Speaker 2:What kind of things are the priorities, the key messages that you try and get across?
Speaker 1:Yeah.
Speaker 1:So I think where it's really exciting what we're working, you know, in thinking about self-regulation and executive function skills, it really helps explain a lot of things to do with neurodiversity and just seeing how we're all different and we're all a collection of skills and um.
Speaker 1:So the first, how we start is really getting people to think about their own skills, so thinking about their own profiles, and particularly when we're thinking about teachers and actually I did a little bit of training in March with the whole school and then this was like a follow-up series of workshops that I was doing and yeah, so getting people and actually I was asking them their reflections today and so many of the teachers were saying, actually my initial reflection is I've begun to understand myself better and then through that comes more compassion and empathy for any of the challenges that the children are that they support, but also with their peers, because what we're talking about is something that's relevant for, you know, for everybody at heart so we deliver programs that are more targets towards nursery age, all the way through primary school, secondary school and, as you know, we've been working with sort of university and you know I've been speaking to some of your connections in Guernsey and sort of you know with you know it's remarkable that I can't even begin to imagine how you would go about teaching preschool children.
Speaker 2:I'm guessing a lot of it is gamified and I know you've showed me some of the little characters and stuff before.
Speaker 1:Yeah.
Speaker 2:But I suppose, for the midwives that are watching or are going to watch this, I wonder how that could be adapted to fit into that kind of setting um, in terms of executive function, I mean, I think yeah, I think it's sort of understanding.
Speaker 1:well, I'll tell you one thing we've been talking a lot about is a model to understand health and mental health and well-being and just so many things, and we haven't discussed this before, laura, but I wonder if you know it. It's called the biopsychosocial model.
Speaker 2:No, I haven't heard of it. The biopsychosocial model.
Speaker 1:So I was discussing it a lot with the teachers and actually when in the school we're working in. But it says considering, say, someone's behavior through what factors are influencing them. We we talk a lot about what influences these behaviors and I think this will be relevant, you know, in the midwifery context, both when you are thinking about supporting mothers through the, the journey, but also actually I know you're also interested in, uh, midwives who are neurodiverse themselves and how they might be supported in the work environment. And I guess it's looking at what influences our health and particularly mental health and behaviour and thoughts and actions and what we do in the moment and that model. So you're looking at the biological factors. So that could be something so neurobiological, particularly so the brain. What's impacting the brain? Could it be a diagnosis of ADHD or autism or dyslexia or just different skill sets? So you just have challenges in working memory. So I'm dyslexic myself. I've got three wonderful bouncy children who are all very neurodivergent and I think they've taught me a lot about, shall we say, executive function, skill challenges.
Speaker 2:That's a very diplomatic point.
Speaker 1:But you know, so it could be something like that, so it could be a challenge with working memory, or I think a big one is cognitive flexibility that comes up. So it could be by understanding behavior through that lens. But then also there are the psycho and social. So psychological elements, so someone's belief in self, so everything that's happening in their internal world psychologically, so the inner factors in their internal world psychologically, so the inner factors. But then also the connection with other people is so important, so that could be how they're relating with other people, that could be their modelling they've had from peers. So lots and lots of things are going to influence all of our behaviour.
Speaker 1:And I think you know I can just well, I know I sort of had three children myself so I've gone through that process and I know having someone who's very close to you and understands can be very supportive. And I guess you're going to see if your journey is midwives. You're going to see so many different character types. And maybe just thinking what might be influencing someone's behavior at any time yeah it's just quite helpful and I think it's a big parallel with that yeah, yeah hugely.
Speaker 2:Um, you said something about a cognitive or neural flexibility, cognitive flexibility, flexibility. What is the difference between cognitive flexibility and, like, neuroplasticity?
Speaker 1:Ah, so I'll explain a little bit about sort of our model. So executive functions is what we talk a lot about. So we'll how we describe things self-regulation, which is an overarching concept to be able to self-regulate, and then, under overarching concept, to be able to self-regulate.
Speaker 2:Yeah.
Speaker 1:And then underpinning a lot of that you have in your executive functioning or executive function skills and there's a number of different models.
Speaker 1:So there are some models. There's a very common model which uses three executive functions working memory, cognitive flexibility and response inhibition. That's really really common and I'm sure you kind of came across that in your recent piece of master's dissertation. And what we do is we actually build on those core executive functions and we think really, what do they look like in practical everyday life as we're getting things done? So we talk more, we kind of go a little bit more nuanced and we think about 11 executive function skills and they're much more practical.
Speaker 1:And I think what's good about this model which is proposed by Peg Dawson and Richard Greer? And they have a whole series of books which anyone watching is really interested in the Smart but Scattered series and they have it whole series of books which anyone watching is really interesting the Smart but Scattered series and they have it for younger children, they have it for teens, they have it for adults. But there's really really fantastic resources. It's the Smart but Scattered series and she uses these 11 skills and so you're asking the difference. So cognitive flexibility is one of the skills and it's sort of imagine you like it really happens in transitions, so big changes or changes to your expectations. So you kind of need your flexibility to adapt yeah you use that in problem solving as well.
Speaker 1:so if you're trying something and it's not working, you might try a different strategy and just thinking about, sort of in a you know birthing context, you might be trying one particular strategy but actually need that cognitive flexibility to say, actually this isn't quite working, I'm going to try something different. You sort of have to let go with what your vision was before and you must have this a lot where someone maybe had a really clear birthing plan or a vision on how they wanted it to go and they have to let go of that and try something different. So I'm sure you must come across people who find it much more easy to adapt to changing circumstances and those who find it a bit more difficult. Sometimes that cognitive flexibility, interestingly enough, is like counter he's got his counterpoint is to someone who's really organized. So sometimes if they're really really organized.
Speaker 1:They can be a little bit more rigid thinking with that yeah whereas people who are much more flexible lazy fear. I have a feeling that both of us find ourselves in the flexible oh yeah, Not organised at all.
Speaker 2:The opposite of that.
Speaker 1:But you know you have that so and I just thought it was a really interesting way of seeing that particular thing by a fantastic psychologist called Dan Siegel, and he's written some amazing books and actually just loads and loads of amazing stuff. But he talks about, for example, that idea of regulation is a bit like a river. You're flowing in the middle of this river. On one side you might have like really rigid thinking. He calls it like the bank of rigidity. You're a little boat floating in the river, but the other side, if you have too much flexibility, it's actually chaos. And so actually what we're talking about is just sort of this river of just having the right amount of flexibility for the situation not too much, not too little and that's why it's so really interesting. It's not so binary.
Speaker 2:even though they're generally good, you can have too much of a good thing that's actually that has made it really relatable for me there, that um, if, if you have too much of that flexibility, it's almost a bit like um. I can imagine the chaos that comes with that kind of complete disorganization. Um comes with that kind of complete disorganization and scattered thought processes, etc. I mean, that's really helped me to understand it.
Speaker 1:I think, using I love an analogy, yeah, well, to answer your question. So another analogy is you were asking me what's the difference between cognitive flexibility, which is that kind of ability to be adaptable, and part of self-regulation. But you were also asking about neuroplasticity. Yeah, neuroplasticity is so, so, fascinating.
Speaker 1:So we scientists used to only know about the brain by if someone had passed away and so looking at you know, you know looking at dead bodies and seeing the brain and seeing what it looked like, but of course it's very, very different to seeing a living brain. And even not that long ago we were understanding a little bit. If people had, you know, clinical problems or damage to a certain area of the brain, they could make assumptions and say, oh, this person has had a damage to this area of the brain and could make assumptions, say, oh, this person has had a damage to this area of the brain and it's caused this change in behavior. Therefore, we assume that this area is impacting this part of cognitive thought.
Speaker 1:And there's a very famous case of a gentleman in the american railroads called phineas gage and he used to be a top level manager and he had a terrible accident at work and if you google it, he had he was putting in a big rod and, you know, putting down the gum gunpowder, whatever he's exploding and tragically, the rod actually went through his skull and damaged the entire prefrontal cortex, which is the area of the brain just behind our forehead and that's where our most complex critical thought processes are coming from and predominantly, the executive function houses are housed predominantly in the prefrontal cortex. Yeah, and phineas gage had this terrible accident. Miraculously he survived. However, his personality was totally altered and so he went from a manager running a team to someone who became really impulsive, started drinking, you know, and actually. But he was functioning on some levels, but this ability to regulate was totally you know no longer as it was so it wasn't that long ago.
Speaker 1:That's how we knew about the brain is seeing those kind of um challenges.
Speaker 1:So you know, we sort of now we understand so much more and I think even the 90s was sort of known as the decade of the brain as we started understanding so much and we could put people in fMRI scanners and I think even more now they're becoming more cost effective and we're understanding more and more.
Speaker 1:And sort of with that understanding there was also a thought that the brain was sort of fixed, you know, in the early days and actually we realized it changes, particularly up until our mid-20s. It changes a lot because another thing we've spoken about in the past as well is thinking about adolescence and how they're still really developing and even within that sort of aspects of neurodiversity. So, for example, an ADHD diagnosis is also going to change some of the maturity of those skills even longer. But there is changes and they can see changes over time, even well beyond 25. We can re-alter our brain. We need to put more effort into changes but we still can't change, always minute effort. But yeah, and it's you know, we sort of again when we deliver our trainings, we really think about the brain and it's so fascinating about how many billions of connections there are.
Speaker 1:And that makes us conscious, be able to be aware of ourselves, and all of these network of individual neurons firing, and that's what's making these messages that allow us to have our you know, conscious experience. And as they're firing, the pathways that fire more often become consolidated and they develop myelin and sheath around them which is sort of. The neurons are really really long cells with sort of you know, dendrites at the end and the big long bit is the axon and it develops this substance called myelin and it's almost like insulating.
Speaker 2:I was going to say that I can imagine it's like one of those foam things that plumbers use.
Speaker 1:Yeah, and we've got. You know, if you look at it, actually it can go the electrical charges down the neurons. If it's got a well-insulated axon can go up to 3,000 times faster. Wow, so they become preferential.
Speaker 2:Is that like almost? You would explain that like it becomes habitual or it becomes just like the normal thought, the kind of go-to thought process?
Speaker 1:the normal thought, yeah, the kind of go-to thought process or yeah, and I'll say there's some great analogies you can do with sort of imagining a really snowy hill. You know. Imagine once a winter you've got a hill in the in the background and it snows and everyone's rushing there with their toboggans. The first time you go down it's a little bit slow, yeah, but the more you go down it is getting faster and faster and faster and that you know. So those kind of analogies, or yeah, walking through a field with really long grass yeah, first time it's really difficult, but then it becomes like a much more long pathway.
Speaker 2:I guess similar to childbirth, then, isn't it? If you have a vaginal delivery for your first one, you know it's the path that's never been paved before, and so usually it tends to be the most difficult, whereas subsequent babies, um, yeah, by default tend to be. I mean not always, the rule doesn't always apply, does it? But um, subsequent babies, in terms of vaginal deliveries, is, it's quicker and?
Speaker 1:Physically and psychologically to have gone through it.
Speaker 2:Yeah, yeah, yeah yeah, yeah, yeah, absolutely yeah, yeah, of course, yeah.
Speaker 2:And the muscle memory and all those things is. Yeah, I mean, it's fascinating, isn't it, how it's all intertwined and that none of it happens in isolation. And I know we talked before belinda about um the the emotional regulation. So I think for me, and I don't know about anybody else, there's um a few people watching on the facebook live, but I don't know about anybody else. And, please, I think I've set it up that you can add questions in the chat, but you know who knows You'll have to read them.
Speaker 1:I can't see the Facebook side.
Speaker 2:Tell me what you can see there, I mean I think I've set it up that people can type in a question, but you know, who knows, I probably haven't. In terms of the emotional regulation, is there any kind of specific things in terms of executive function that you can build on to improve your emotional regulation?
Speaker 1:Yeah, there's so much. It's really interesting thinking about emotional regulation. Obviously, in the school today we were really thinking about the developmental side of what it looks like over different children, the developmental side of what it looks like over different children. But I think, you know, even just thinking about it more in an adult context, you know whether that, as I said, is any midwives who are watching were thinking about themselves or how it might be supporting someone through their journey as a midwife. I think it's just having that emotional awareness. Talking about it is sort of really important. And you know I was mentioning this sort of model, thinking of things under those three categories the neurobiological, the psychological or the social, actually also thinking about their journey or your journey, like what's impacting it. So, yeah, it could be something on that neurobiological level. So, as ADHD diagnosis are really really clearly linked to emotional regulation challenges and you know, I think that, particularly in some of the diagnostic criteria, is not really well discussed.
Speaker 2:It's not at all, is it? And actually I don't know if you see any of Russell Barclay's videos on YouTube and he talks about how they removed those emotional elements from it and there's a massive campaign to get it reinstated, because that is one of the main key features of ADHD is that emotional dysregulation isn't it?
Speaker 1:Yeah, absolutely, and I mean I'll divert for for a second. But so when my son was first diagnosed with ADHD and I didn't know so much about it, I had two facts. I knew that all I knew about ADHD was kids run around like a gymnasium bunny who's had some tartar disease too many smarties. Yeah, exactly, and too many kids in America are on Ritalin.
Speaker 2:That was it.
Speaker 1:I had two factoids. That's it yeah, and I think what it is is. I never, with George, I saw that emotional side, but I had no idea that that had anything to do with ADHD, because it didn't fit in that very, very limited, you know, view that I had, and I even remember saying to him do you think that your emotions are stronger than other people? And it was sort of as we were understanding things and yeah, the emotional side is really really tricky for him.
Speaker 2:you know, even now.
Speaker 1:And yeah, also to touch on Russell Barkley, I think amazing he sometimes says actually ADHD would be better known as executive function deficit disorder.
Speaker 2:Yes, exactly yeah.
Speaker 1:Much, much better. Name. Might even be a better one. That's not so much of a deficit model.
Speaker 2:Yeah, yeah, anyway, let's take that for now.
Speaker 1:But yeah, about emotional control, I think it's understanding. So developing one's own emotional understanding as an adult, checking in like what's impacted us, what's triggering us, and building that knowledge. I think understanding what's what is impacting that. So is it, say, a diagnosis? Then thinking about the psychological side, is there something inside? Are we telling ourselves these continuing beliefs or value systems, like where's it coming from? Like a lot of people have, you know, really can challenge their negative self-talk and change it to positive self-talk, and there's lots of great coaching models that can be done to kind of build on that. But then also some social aspects. You know, was was it something? How were your parents?
Speaker 1:around you Like, did they discuss emotions? Or, you know, did they lose their temper? Like, how did they model things around you? And it's really I mean gosh, so many things. But so understanding it and unpicking it and sort of giving yourself a narrative, I think I One thing going back to sort of some of the neuroscience that underpins the approach we have at MindSpark is, again, this is I mentioned Dan Siegel earlier. This is another concept by Dan Siegel which is called, you know, the hand model of the brain.
Speaker 2:The hand model of the brain.
Speaker 1:Yeah, have you come across that?
Speaker 2:No.
Speaker 1:Well, I'll show you. We have it in our training, but it's sort of it also overlaps with a lot of trauma-informed work that's going on about how the brain works. So I was saying that the effective functions are predominantly in this sort of most developed part of your brain. So your brain is more developed the higher up and the further forward it is. So it's most basic there, most developed here, basic there, most developed here. And so imagine your hand. This is your prefrontal cortex here and, as if I'm looking that way, you've got your amygdala here in the middle and your sort of brainstem. You've got your primitive breathing functions here and the more emotional side of your amygdala in the limbic system, and then over the top you've got your top-down areas. So the top bit of your brain is a bit like a watchtower, your upstairs brain, and this is all in sort of some of the trauma-informed approach. So this is here and it's like a real thinker.
Speaker 2:Air traffic control is up there.
Speaker 1:Yeah, exactly. But what you've got down here in the more emotive section is like it's a fire alarm. It's either on or it's off. It's either safe or it's danger, and if you're in the downstairs brain it's more like a fight flight freeze response, which is just on or off, whereas the top down brain is much more complex. So if you get triggered emotionally you flip your lid and it's really interesting if you look at the neurobiological circuitry it actually bypasses.
Speaker 1:There's a whole separate pathway that goes down and the whole process is go straight to this limbic system and right we heard the phrase amygdala hijack and it's like yeah you know, see, flip your lid and you start operating from this fight, flight freeze, yeah, and you don't have your rational thoughts, yeah, and it takes time, and it takes different people different times. And again, thinking about your midwifery context, you know, I'm sure you're going to see, we'll be supporting mothers who do flip their lid. There's a very different approach how you speak to anyone if they flip their lid because you're not able to talk to this rational brain, and so we can think of that in the context of a child having a tantrum, or we can think of it in the context of two adults having a tantrum.
Speaker 1:You know two adults having a disagreement and both flipping their legs and we know you're not going to have the same rational conversation of two adults who got triggered.
Speaker 1:You've got to wait for time for them to regulate and then you can come back together and I think, taking that you know toddler, having a tant, you know toddler, hurry attention. You know actually what you offer as a parent and you'll know this story. You're with them and that co-regulation is very, very different and you don't want to solve their problem in the moment because they're not receptive to listen to that.
Speaker 1:You just have to be with them until they calm down and then, in a quiet moment when they're calm, you can start trying to unpack what happened, what we do differently and, um, you know, and I think that course of what you were saying, particularly if there's midwives themselves who are watching this and they're thinking about how to regulate their own emotions again, it's just building that awareness, yeah, and going oh, I flipped my lid. Okay, that's fine, I need to do something different. That's the thing you know, sure you'll know, but all techniques, even like deep breathing, what that's doing is you're actually soothing the body from the bottom up. So, as well as waiting for the top down yes, come back online you're actually regulating it from the bottom up.
Speaker 2:And there's lots of other things that you can do with building that awareness, I think, and self-compassion, first and foremost and so, in terms of when you do flip your lid, your executive function is just yeah, you just don't have the same access to that rational problem solving.
Speaker 2:And so I wonder then how that all interplays with and I know we've spoken about this before, I've wrote about it in my dissertation about the impact of hormones and, um, the effects of oestrogen and dopamine together and when?
Speaker 2:Um, obviously there's many other hormones and neurotransmitters that are involved, but if we think about it in the week before my period is due, when my oestrogen level is lower, then so is my dopamine level and I'm far more easy to trigger into fight or flight in that week.
Speaker 2:And therefore, even if I'm not triggered in fight or flight, I definitely find that my ADHD symptoms are worse and my executive function is markedly reduced, that I go to the wrong place, I turn up at the wrong time, I'm two hours early, or I'm 40 minutes late, or a week early, a week late. I just kind of seem to grasp how and that is me medicated as well, and it's still not. I know there's a few situations where the psychiatrist will mitigate for that kind of week in your period and maybe do some medication alterations or add in another one, but it just intrigues me then that you know I might not necessarily be in or don't think that I'm in fight or flight, but it's the impact of my hormonal cycle that's factoring into that there. I just find it all really fascinating that, um, I wonder what the intersection is, as if I can't access my executive function yeah, I mean it's really interesting.
Speaker 1:I don't know enough about the research. I've seen a few things and we've discussed it, but I think it is really fascinating.
Speaker 2:And I think there's probably still lots of things to come. It seems as if there's lots of really good research that's happening.
Speaker 1:It's coming out at various yeah, I'd love to hear more about your dissertation as well, what you found thinking about Also, because it's a lot as well about the pressures after birth, how those symptoms yes, yeah, yeah.
Speaker 2:So it was um, the, the, the recent, if I can find my words um. The research title was the um executive function experiences of postnatal women um with ad, adhd in the context of early parenting. So it was looking at it from a feminist standpoint perspective and the pressures of becoming a mother and having children. There's a lot of pressure there as a baseline. Then you add in that component of um, you know, reduced, markedly reduced executive function.
Speaker 2:When we think about what happens to estrogen, your estrogen levels during pregnancy, in terms of adhd, a lot of women in pregnancy tend to find that their ADHD symptoms are much better, they're not struggling as much, their mood regulation is much better. But then in that acute postnatal period we see a very, very sharp drop, like your estrogen level just jumps off a cliff, yeah. And with that then comes you know all of the, the usual emotions that women would experience in terms of the baby blues and that kind of day three, day four, um, shifting of the hormones. So you're having all of that as well as you know your adhd symptoms coming back, or man, or becoming a parent for the first time, because a big issue is that a lot of women who are having babies in this generation don't know that they have ADHD or that they're impacted by this in any way, shape or form, because of the historical bias towards males in the research.
Speaker 1:And also some big one lack of sleep.
Speaker 2:Exactly, lack of sleep, all of the you know the executive function demands on trying to meet the needs of your baby, processing all of the things that have just happened to you during childbirth, and you know that, and then the physical recovery of childbirth. You might have other children. It is a lot to cope with, I think, for any, for any mother, um, but I think that you know it's magnified then, isn't it?
Speaker 1:and I imagine it must be so different as well, depending on to the family support that you might have or relationships you might have part yeah, part, of course, part of the support that any other members of the family that might be there there's so many different setups, aren't they? Yeah, you might have people in different things, or even, you know, I'm sure, single mother as well.
Speaker 2:You're gonna have even have even more pressures and the thing is, there's research to suggest that mothers with ADHD are more likely to be single mothers.
Speaker 2:You can imagine with perhaps challenges, with response inhibition that might be a factor, but feeding into those core values that you have about yourself, maybe not selecting an appropriate partner to have children with, etc. And the other thing is that I don't know it's gone out of my head and that obviously it obviously one impacts the other, doesn't it? Because, like, for example, I was at the park yesterday with the kids. We walked up to the park. I hate the park. There's nothing interesting for me at the park. That sounds really selfish, but I don't like just relentlessly shoving them on a swing. Push me, mum. I'm like, oh my God, oh my God, this is killing me. Like, can we just go and get an ice cream? Can we walk? Can we go and feed the ducks?
Speaker 2:I just find it really mind-numbing. I don't get anything from. I mean, obviously it's nice to see your kids enjoying themselves, but I do find it really boring. So I struggle and I remember struggling to engage or be present and you know, do all those kind of eye contact, cooing, being responsive, all those things that are helping those neurons to connect in your baby's brain? Those things are going to be more difficult, I think, for those of us who are challenged with executive function and ADHD, because it's just not, I don't know. It's just difficult in your brain to feel the urge to do those things or to do them and be like, oh god, this is terrible.
Speaker 1:I mean, I guess what you're describing as well is sort of situations like going for an ice cream, going for a walk, even in that context are the more quite exciting.
Speaker 2:It's moving around yeah, yeah.
Speaker 1:And if you're used to your life like that and again thinking about the journey of perhaps a first-time mother who is then having a child, it's like all of a sudden they've been on the go, for example, and that type of personality.
Speaker 2:All of a sudden they're having to be much slower and still and that must be a big challenge, yeah especially, I mean during, I don't know recovery from a c-section or whatever um being forced to slow down because your body just won't allow you to move the way it used to.
Speaker 2:Um, I think there's a lot of factors that that feed into it. Um, you know, things like impulsive spending. So the research, the semi-structured interviews that were done through the research, and each of the mothers described at some point or another becoming a bit hyper, fixated on buying stuff for the baby, and they had an abundance of stuff. And I'm sure that's the same for even neurotypical mothers, but I think, even more so, more likely to get into debt in order to feel as if you're getting all of the stuff that you need all at once. But actually you know you don't need to have the baby's cot and the baby's wardrobe and stuff to begin with, as long as you get somewhere for the baby to sleep. But you get a bit carried away and I remember being like that myself, looking at different varieties of every possible aspect of having your baby, and then I really hyper focused with the third one on um, reusable nappies, but the dopamine hitters, you get from them.
Speaker 1:I did reusable nappies, but I did it the other way around. I did it for my first lots less for my second, even less for my third. Yeah, um, but one thing I just thought I'd mention in this chat, which I know we spoke about before, was we were talking about different birth journeys. So my births were so incredibly different from my first, second and third and they another part of my motherhood journey was increasing prematurity.
Speaker 1:So okay, so they were getting earlier and earlier yeah, so my, my eldest daughter, who's now 16, she was born 39 weeks. It was a long labor but it was like natural birthing, pool birth hypnosis, you know, loved all of that. It was a bit in the pool and long labor, did not even a night in hospital. She yeah, it was, you know, home the next day and you know there was uh. But that was kind of fine and actually my early motherhood journey.
Speaker 1:There's a lot of things that were were complex for me. What was really tricky was actually breastfeeding. I ended up with terrible, terrible mastitis. I had to go back into A&E seven days after she was born and it was really, really intense and I mean that was fine. I just had to move on and you know, she was breastfed for a week and then I moved to potter feeding but it was like that was. My second child is now 14. Um, he was born. I started like my water started leaking a little bit around sort of 34, 35 weeks and I went in. I think there was a rupture in the amniotic sac and I think there was extra water, the amniohydrus.
Speaker 2:Polyhydramnus, but more than you need.
Speaker 1:More than you need. They picked up in the 20-week scan a little bit of dilated bowel lube. So they were wondering. They said you can't have a home birth, you've got to come in. I said OK, but anyway he was born and they didn't quite make a plan for him, so they should have done. And I was discharged into the postnatal ward and told to be feeding him through a syringe and basically part of his intestine hadn't grown, okay, and he was five weeks early and he had some. So I'm quite up on my neonatal gastroenterology. Oh, so he had a genital. I'm quite up on my neonatal gastroenterology. Oh, so he had a jejunal atresia Okay.
Speaker 1:Where part of the jejunum just hadn't grown. It was a bit of connective tissue, so below his duodenum. So jejunal atresia. He had malrotation, which is when the whole intestines are forming. It kind of comes out and then twists in a certain way. His are twisted in a wrong way and at the same time he had a volvulus, which is when all of the intestines wrap around each other.
Speaker 1:I can imagine that's like a big knot of spaghetti, exactly what it is, but it's really risky because the loops, because obviously it's living tissue. It's like if you put a rubber band on the end of your finger it necrolises the tissue or it has the potential to so. Luckily he had a massive operation the day he was born and he's fine. He does have ADHD, he's dyslexic, but he's great as well and I do think that journey kind of exacerbated his ADHD, his birth journey. And then I'll just share briefly about my youngest. I twisted my husband's arm to go for a third.
Speaker 2:His arm. I don't think it's his arm that done it.
Speaker 1:And Zach, my youngest, was born when I was 24 weeks pregnant. Oh gosh, right on the cusp. Yeah, yeah, exactly, and that's you know that was a hell of a journey. So my, my waters actually broke at 23 and a half weeks and luckily he, I didn't go into full labor for 10 days and that was really important. I managed to get the two doses of steroids. Yeah, yeah, you know, but that was a different journey.
Speaker 1:But yeah, just thinking about journeys of motherhood and how different they can be, and just the different pressures that came with all of those different births and because they were getting more and more complex and each time.
Speaker 2:I had younger children to look after. It's very aye, and what was the practical situation in terms of that then?
Speaker 1:You had a longer hospital stay, I would imagine.
Speaker 1:Did you have to travel. How long was he in the neonatal? For about four months, um, and the how it was set up was there in chelsea, westminster, the three different zones there was sort of the intensive care, the high dependency and special care all in the same, nicky and he spent about a month in the high dependency, about a month in the sorry icu nicky proper, then a month in the high dependency, about a month in the ICU NICU proper, then a month in the high dependency and then about two months for feeding and special care. And it was tricky we were released with he was basing on home oxygen and a feeding tube. I had those for two years, wow, used to walk around with know, maxi cozy and a feeding pump and an oxygen cylinder. Yeah, you know, and doing all of that whilst juggling two-year-olds and four-year-olds.
Speaker 2:so just thinking about, yeah, the kind of pressures, yeah, yeah exactly, and then and then all of those um, societal pressures on you know those kind of unspoken things, but the things that we know are expected of us to be organised. Which actually brings me quite nicely on to the next thing that I wanted to ask you. I guess it loops back into your core values and how you regulate your emotions of core values and those like how you regulate your emotions. And one mother that I spoke to for the research described about, she was maybe about two weeks postnatal and with her first baby and she obviously has ADHD and she turned up for an appointment with a health visitor a week late.
Speaker 2:She was subsequently chastised by the health visitor and she got in the car, obviously, and then drove home but was sobbing beside herself and that we talked a bit about the rejection sensitivity aspects there and how that's really difficult to navigate, that it feels very much like it's not within your control, um, to navigate, but I'm assuming that kind of all links into your the broader topic of executive function, um, and I mean it's just obviously there was things factor in like the lack of compassion that she showed and it's really difficult to understand and this is why the education is so important, isn't it that? Actually, if you could pause that moment in time and just say to that health visitor listen, this is actually what you know in terms of her hormones, this is exactly what's happened. But why would you chastise anybody? You would just be like, look, look, you missed the appointment. Let's either just get you seen Now. It's baseline compassionate care, but we know that that doesn't always happen.
Speaker 1:And I think all those work comes from. That compassionate approach is assuming that someone is doing their best, yes, and assuming that that mum is having a tough time, that she's being the best mum she can be, she's juggling all of these factors that are influencing her and coming from that, you know, being the starting point. It's interesting when you talk about compassionate I've been, I can't remember. Remember I sent it to a few people, um, but I was looking at the different types of empathy did I send that to you yeah, yeah, and I just thought it's so fascinating.
Speaker 1:it's part of training of how to really understand empathy. Yeah, this might be something very relevant to those listening today is thinking about empathy and I'm just seeing it as one block. There's actually some really good research and I'll send you something you can post on the Facebook group or, you know, I can add it the different types of empathy and I'll just share a few of them because I think it's really fascinating. And the more you're aware of it.
Speaker 1:Then you can communicate your empathy more efficiently and I think in the role as midwives, that's going to be such an important part of what you're doing all the way through the journey is communicating it, because it's not just you feel it, yeah, you demonstrate it, yeah. And so there's one of them is sort of you know what we might associate with empathy, like feeling someone else's feelings. So it's quite empathic resonance. So if someone's feeling sad, you actually feel a bit sad. You take on that feeling. If they're, you know, excited, you feel a bit excited.
Speaker 1:So that's the sharing and then the next one is sort of perspective taking. So what would it be like if I was in their shoes? So this health visitor you know would have if she'd have understood, what would it be like if she had some of the empathy on those levels perspective taking. Another one is empathic understanding. So what would be going on for this person that's made them behave a certain way? And back to that kind of biopsychosocial model like what are the factors influencing that person at that time? So it's more thinking about it rather than that energy level, rather than perspective taking.
Speaker 1:It's like actually let me really think what I know about the situation.
Speaker 2:Yeah. What circumstance are they in?
Speaker 1:know about the situation. Yeah, what circumstance are they in thinking about the circumstances and the influencing factors? And then the next one, which is very interesting, is, um, you know, empathic concern, and that is a synonym for compassion, and the way that's sort of described is really it's sort of I feel your pain and I want to do something about it, and I really like it. I think it's the action-oriented side of empathy and I actually think in everything we do at MindSpark it's almost actually that captures it, because it's not just the empathy. We want to do something about it, we want to help, we want to empower someone to do something about it.
Speaker 1:And then I will just share the last one, because you've got to end on that one is the fifth. One is empathic joy, which is actually sharing in the success of you know, sharing in other people's success as well. Anyway, I think, but you know so I think with all of these things sort of there's a lot of great communication, but I'm such a believer, if you understand it, it just makes you think a little bit more a hundred percent.
Speaker 2:Yeah, it's like that. I know you touched on kind of that trauma-informed perspective, that that for me, I think, once you understand the potential traumas that people have been through in their life, I find it very difficult to feel sorry for criminals. No, I find it difficult to not feel sorry for them or to kind of empathise on some level that God, they must have had a really you know, probably a really difficult childhood. Who was there supporting that child when they were two, three, four, five years old? What must they have been through in their life that's led up to them making these decisions? And it's almost like it should be the baseline from which we work, that those levels of empathy and obviously trauma-informed care. But sadly, that is not the world that we live in, is it?
Speaker 1:No, and I think actually what's also fascinating is thinking about intergenerational trauma as well like that is really fascinating how those, those challenges and those belief systems are being carried on through different generations, and you can think of it, can't you? We were talking about the importance of modelling, of, say, how your parents might have either handled disagreements or how they spoke to you. Did they talk a lot about emotions, did they, you know? Did you unpick problem solving together? How did they talk a lot about emotions, did they, you know? Did you unpick problem solving together? Like what? How did they interact with you? You can see how that will be passing through different generations. Oh, yeah, for sure it was interesting.
Speaker 1:One of my best friends is from new zealand and she has maori heritage and it was really interesting. We were discussing this over the weekend and she was actually talking about some of her cultural views of herself. She's taken on some of this intergenerational trauma, as you know, from the challenges that the Maoris have gone through in New Zealand, and actually that's part of her identity and culture, and so even that kind of you know, I guess I guess it taps into a lot of racial discrimination as well, you know, and we've we've done some work with a fantastic charity called education for change, which is based in newham and we work, we've done some work with them, because growing up with racial discrimination or toxic stress or you know lots of adverse sick conditions you know we can think of. You know parents who are really struggling financially or doing lots of jobs, who aren't able to be there as much as they'd want for their parents also for their children.
Speaker 1:Yeah, you're going to have less of those interactions and how we're developing our executive function skills, our ability to interact with other people, is like there's a great phrase it's a complex interplay between our genetics and the interactions with our environment. If they're going through their child development and they're growing up under toxic stress and there's some great work by the Centre for the Developing Child, which is attached to Harvard University, and there's some great resources there and about how if you're growing up under toxic stress, it changes again back to that neurobiological structures.
Speaker 2:Is that Nadine burke harris, or nadine harris burke, um, is a pediatrician and she, um, it's all about, um, toxic childhood stress, um, and I how obviously it is a massive contributing factor to many different types of physical and emotional illness. Um, it's a huge topic, isn't it, and we're not going to solve it on our Facebook Live.
Speaker 1:We can touch on it Exactly.
Speaker 2:I don't know if anybody has any questions. The Q&A thing, I thought I had turned it on before but I've turned it on now. If anybody has any quick questions, write quickly. But we can. We'll obviously make sure that this video is uploaded to the private Neuro Midwife group and we can also put in some links to the different resources that Belinda has touched on tonight. And yeah, I mean it's been really interesting chatting to you, as usual Belinda has touched on tonight. Um, and yeah, I mean it's been really interesting chatting to you, as usual, belinda yeah and I think yeah.
Speaker 1:In summary, I think it's just thinking about communication, thinking about connections, understanding, like that compassion I think is so central isn't it and it's building that. You know you said compassionate care.
Speaker 2:It's building that into conversation but it's also showing yourself that, isn't it?
Speaker 2:self-compassion absolutely, because just from my own personal experience, I, previous to my diagnosis, I was horrible to myself, that inner narrative that you've got going on in there, especially during those times of poor executive function when I was late or I would go to the wrong restaurant and my friends would all be sat um waiting, you know, for me at a different restaurant. And then I'm phoning saying like where are you? I don't know where you are. And then like, oh, where are you? And I'm like, oh, I'm in such and such a place. And then they're like, but we're all you know.
Speaker 2:And I would be like historically really horrible to myself, saying like you're such a stupid bastard, um, but actually showing yourself that comparison, compassion, um, is where it all starts to kind of change your outlook a little bit, to say, well, do you know what? You're giving yourself a bit of a hard time if you can understand that xyz has happened and that's led up, this has been the catalyst for me making this mistake now. But just go gently yourself, it's a big deal. I'll just go along to a different place.
Speaker 1:I'm late we were talking earlier about neuroplasticity. Now, interesting neuroplasticity is also on thoughts as well as behaviors. So actually sometimes, whilst we can use it to our advantage, also, if you're going to have repetitive negative thoughts, those also are the ones that kind of become the default yes, the pathways yeah.
Speaker 1:And there are some sort of fun exercises you can do in coaching. Talking about ants, automatic negative thoughts, but almost you can like play a mind game, going like they're little ants and like you've got to get rid of these little. Yeah, flick them away, because it's like a picnic, you know, if you've got your straw and your cake out, so you've just got to like yeah yeah, ping them away?
Speaker 2:I quite like to. I heard somebody talking about once in like a youtube video or something about how personify that inner critic that you've got. Visualise them like as a I don't know one of these what are they called? Hologram type things. Give it a name and say thank you so much. I know that you're trying to protect me in some way, shape or form, but I need for you right now to sit down on that chair in the corner and mind your own business, because I deserve some compassion.
Speaker 2:That sounds very NLG your linguistic programming.
Speaker 1:You could also do it where you kind of similar to that you can have like two voices, almost like the good voice, yeah uh-huh yeah yeah, you're a critic and you're in a coach and they're fighting and you could I've done some really fun sessions with with children and this obviously is relevant for adults and then kind of go, when you're tough, what would your kind of inner coach? And they give it a name. Yeah, and it was great. I did you know one session where this child was, he'd been excluded from school and was trying different things. I said what would you know? Whatever his character was, he gave it a name and there's a whole character to his own thing and he was sort of giving it a voice, saying, oh, go on, don't be that bad.
Speaker 1:But it was just what he would say to himself if he wanted to encourage himself and, similar to you, were talking how you'd say, acknowledge the inner critic, but it was more he actually. We even wrote on the pushcards these encouraging things, but it was more he actually. We even wrote on little pushcards these encouraging things, but it was his language his own narrative for himself.
Speaker 2:Yeah, yeah, it's got to be relatable, doesn't it? He was disgusting at it.
Speaker 1:He did that. So, yeah, I think you know back to, I guess, sort of thinking about this in the context of midwifery. I think all of those skills are really, really important, both as well supporting women and understanding them.
Speaker 2:Yeah.
Speaker 1:But I think you know, as we're saying, you know as well, thinking about your diversity in the workplace and that self-compassion.
Speaker 2:Yeah.
Speaker 1:And understanding peers and sort of workplace.
Speaker 2:Yeah, for sure. Well, I've got a comment on here from Emma Wren, who says she doesn't have any questions, but just a thank you. It's absolutely fascinating and gives a lot to think about, so I'm glad you enjoyed it, emma. Obviously, the video will be there for anyone else to look at who couldn't make it along tonight. But yeah, it's been lovely chatting to you, belinda. Thank you so much for taking the time. After a very busy day, you must be exhausted. It'll be time for a big glass of wine it might be Monday night, but that's fine.
Speaker 1:I think I deserve one start the week, as you mean to go on.