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By: Nancy Niessen

As I was pondering writing a post about Step 4 of Shanker Self-Reg, I began to reflect on stressors in the different domains for both my mother and I on the days she goes to medical appointments, when there are many stressors for both of us. This got me thinking: I was seeing her pretty much solely on days when she had appointments – the most stressful time for both of us! Since I’ve become aware of that fact, I’ve tried to initiate more contact with her outside of appointment days even if only via email, about non-stressful topics like our shared interest in plants and gardening. I think this has made a difference for both of us – she’s no doubt feeling more connected and I feel more positive about our interactions.

As I thought more deeply about our stressors and worked through the modules in the Level 2 Facilitators’ course, I came to more fully understand that reflecting on stressors is not what Step 4 is about. Rather, “Reflect” is about developing our stress awareness and an understanding of what it feels like when we are becoming stressed, especially when we are becoming over-stressed. Step 4 is also about developing an understanding of what calm feels like. As we come to understand what both stress and calm feel in our own bodies, we are in a better position to go back and recognize and reduce the stressors that cause tension and that cause us to expend energy.

I regularly apply Step 4 on the days my mother has medical appointments. I’ve learned to do a check-in with myself in terms of how I’m feeling in the different domains in order to know what my energy/tension state is. I’ve learned through reflection how I can reduce or mitigate some of my own stressors.

  • Biological: Am I rested? Did I eat breakfast so my body is fuelled? Am I in comfortable clothes so I’m not too hot or too cold? Are my allergies in check? Do I have a headache and if so, what might I do about it?
  • Emotion: Do I have any big emotions going on that might be an indicator of stress in any of the domains?
  • Cognitive: Is my head full of other things I must do? Am I clear on what this appointment is for, and does my mother understand what it’s for?
  • Social: Do I have my partner on stand-by for a text should I need some co-regulation? Do I need some alone time or, conversely, social connection afterwards?
  • Prosocial: What are my stressors going into this appointment, about whatever my mother is having done? This is something I’ve previously not given enough acknowledgement and in fact have blocked it out to some extent as a way of trying to cope.

Self-Reg is about thriving, not just coping.

I try to be sure, if possible, that I have nothing else booked for an appointment day as another way to minimize my stressors. Getting a good rest the night before also helps as does leaving early enough that I don’t feel rushed, especially since parking is typically a big stressor for me because of where my mother’s doctors are located.

I become aware on appointment days when stress begins to build up: I notice my jaw is clenched. I might take a deep, “sighing” breath from time to time. I hold the book I’m reading more tightly. What do I do about the building tension I’m feeling? My body is expending more energy because of the increasing stressors in play – how can I address the stressors in the moment? I connect via text with my partner or friends for some co-regulation. I get up and move instead of sitting still in the waiting room. I do some deep breathing, more than just a sigh, and notice how my heart rate and breathing slow and become more in sync. Sometimes, quietly reciting a mantra in my head has the same impact.

I am aware of my own energy and tension states, and am pretty clear on how my mother is feeling. In an effort to be increasingly sympathetic, I’ve pondered what her stressors are on appointment days. I’ve suggested bringing a book or a fidget toy as a way to reduce her stressors. But what does it mean if I’m looking at Step 4 with my mother in mind? How can I help her to be aware of her own stress, energy and tension states? Perhaps more importantly, does she know what it’s like to feel calm and how to get to that state with intention?

During our last appointment she was particularly agitated. I asked my mother why she was so annoyed about waiting, since she knows we always have to wait, we do every time we see this particular doctor. I shared that I’m never surprised about waiting, but rather am surprised on the occasional day we don’t have to wait. I’ve reframed the waiting positively and consider it a stretch of time to read my book. Initially my mother was defensive, wondering why it wasn’t okay to make a comment about waiting. I calmly explained that I was just trying to understand why she was annoyed. She eventually said she hates sitting still, and has never been able to. I wondered aloud if it’s not a good thing to be still now and again. And then the golden nugget of the conversation came out: I typically book my mother’s appointments for the morning and that is her productive time of day. It’s usually when she is working in her garden. When she is sitting in the waiting room in the morning she’s thinking about what she might have done in her garden or around the house. I was delighted to hear my mother’s awareness shared. At 94, almost 95, she has limited energy for physical activities on any given day. 

As I contemplated her response, the lightbulb went off in my head about a possible way to reduce some stressors for her: I suggested that I book her appointments for afternoons instead of mornings. She didn’t want things rearranged but she said she does have an easier time sitting in the afternoon than in the morning. So I’m going to do a little Self-Reg experiment and will start booking her appointments for the afternoon and see if that makes a difference for her. This is the beginning of trying to draw my mother’s attention to her energy and tension states so that we can try to mitigate some of the unavoidable stress on her appointment days.


Nancy Niessen is a retired elementary teacher whose career spanned over three decades. Most of her time was spent in the Early Years and Special Education. During her teaching career, she also instructed ETFO’s Kindergarten Specialist AQ and was part of her local Reggio Study Group. Nancy is proud to be a Cohort 1 graduate of TMC’s Foundations Program and is delighted to be enrolled in Level 2 which allows her to delve even deeper into Self-Reg learning.