Why Caregivers of Autistic Children Need Mindfulness

Why Caregivers of Autistic Children Need Mindfulness

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Guiding individuals through emotion is at the heart of my work as a therapist. Mindfulness interventions are what I most often turn to when supporting individuals in working through their feelings, whether this be clients or my own neurodivergent children. The practice of mindfulness is effective for reducing the intensity of anxiety, depression, and addiction, as well as numerous other conditions that have at their core managing challenging emotions.

Autistic children experience higher rates of comorbid internalizing conditions, such as anxiety and depression, as well as externalizing conditions, such as oppositional defiant disorder, than their neurotypical peers. Approximately 70 percent of autistic children experience at least one other comorbid diagnosis (Mattila et al., 2010). These heightened comorbidity statistics are likely influenced by factors such as unique sensory processing, navigating challenges in bi-directional social understanding with nonautistic peers, or biological variables such as decreased respiratory sinus arrhythmia (RSA), a measure of heart rate fluctuations. Caregivers of autistic children also report higher levels of physiological distress, stress, and depression than carers of neurotypical children or carers of children with other challenging conditions (Factor et al., 2018).

Hence, supporting neurodivergent families in coping with their inner experience is of particular relevance not only to the young persons themselves but also to their caregivers! And mindfulness interventions have shown wide-ranging benefits for autistic young persons, including reducing externalizing aggressive behaviors (Singh et al., 2006), as well as being effective in reducing levels of depression in their caregivers (Hartley et al., 2019).

Mindful parenting

Individuals exist within the dynamics of their families, as well as the wider environment and society. Research tells us that how caregivers relate to their inner experience and respond to that of their loved ones has an impact on autistic children’s coping (Raulston et al., 2021). Mindful parenting, defined as “purposefully and non-judgmentally paying attention during caregiver-child interactions and the relationship as a whole” (Raulston et al., 2021), has been associated with increases in carer well-being and reduction in the experience of carer stress, as well as reduced frequency of behavioral challenges in autistic children (Raulston et al., 2021).

Ideally, nurturing mindful awareness is recommended as a goal for the whole family (Hartley et al., 2019) because parental practice of mindfulness is likely to impact children’s responsiveness to mindfulness interventions.

Defining mindfulness

Mindfulness is a subjective experience of one’s awareness. Through factor analysis of popular mindfulness measures, Baer et al. (2006) identified its five key traits: present-moment awareness (paying attention to one’s experience in the here and now), non-reactivity (not responding to a situation from a reactive place), naming your inner experience, non-judgmental attitude (not responding to a situation from a place of judgment), and self-observation (noticing one’s inner experience with curiosity).

Facilitating the above five traits of mindfulness can nurture positive emotional self-identity and increase the experience of positive emotions in families.

Facilitating present-moment awareness

Present moment awareness is a component of mindfulness most included in its definitions. Through the use of fMRI, Farb et al. (2007) found that while experiencing here-and-now awareness (or what the authors termed experiential focus), the neural circuits in the brains of participants shifted away from ventral medial prefrontal cortex and amygdala towards more lateral prefrontal regions, reducing the experience of anxiety. The here-and-now experience is associated with an increased experience of positive emotions, reduced vulnerability to illness, more “objective analysis of introspective and extrospective sensory events,” as well as the production of nourishing enzymes such as telomerase, to name just a few of its benefits. In contrast, mentalizing, or what the authors referred to as a narrative focus, is associated with greater judgment in reference to the self and vulnerability to illness.

Coming back to the here-and-now experience can be incorporated into any family activity. Intention is the key, as well as seeking opportunities to deepen awareness of the introspective and exteroceptive experiences in the present.

Tuning into the sensations around me feels, for me, like the shifting of gears, away from mentalizing and the hurried pace of demands to (usually nature’s) unhurried pace, vibrant, gentle, serene. Whether taking time to notice patterns in shells, listening to the sounds of nature with closed eyes, watching clouds, or being present in a conversation, the habit of mindfulness and its benefits increase with repeated practice.

Facilitating non-reactivity and non-judgement

Clearly, non-reactivity, in the literal sense, is an impossibility, as all of us are continually triggered by people and events around us, especially by those closest to us. Non-reactivity does not refer to a lack of an emotional response, which is impossible and something outside of our control. Instead, non-reactivity refers to our responding to a situation from a place that is not enmeshed and over-identified with our reaction.

One strategy that I put in place with my 9-year-old son that targets the practice of non-reactivity is firstly acknowledging the strong urge to want to react with an immediate action when feeling an emotion; instead, I pause. I encourage my 9-year-old to feel his feelings, pause, and then respond with a moment of self-care (such as having a snack).

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Instead of responding to an inner experience with judgment (given that society is full of myths about how much, what, and when we should be feeling), mindfulness feels like a corrective experience of receptivity and curiosity. Instead of judgment, inner experience is explored with a kind, compassionate awareness, which has been found to increase levels of oxytocin in the body (Bellosta-Batalla et al., 2020).

Observing self

The observing self is the curiosity that paves the way to learning from inner experience.

Within my family, a fun way to nourish curiosity is through conducting experiments! When my son misses a basketball shot and concludes that he “always misses” the basket, an experiment that subtly questions his beliefs may be tallying the actual number of shots he misses across 30 attempts. Another strategy that we often make use of that loosens the grip of a black-and-white mindset is coming up with at least two different explanations for why something may have happened instead of believing one automatic conclusion that is most likely limited.

Another example of a CBT-type strategy for nourishing the observing self is drawing a thought bubble and, inside it, writing down or drawing feelings and thoughts. Examples of questions that can be asked are: “What color do I feel?” “What words am I saying to myself?” “Are they kind?” “What words of encouragement and ideas for self-care can I add to the thought bubble?”

Mindfulness can be a valuable resource for working through emotion, with supporting evidence backing up its effectiveness. Mindfulness helps to connect emotional experiences with introspection, increases one’s ability to induce calm, and increases the experience of positive emotions, to name just a few of its benefits.

What I appreciate most about mindfulness in my own parenting journey is the receptive nature of this experience. Caregivers of neurodivergent children often cope with attitudes of judgment and criticism, whereas mindfulness supports them in tapping into a mindset of exploration. The receptivity of mindfulness helps me learn about how my children experience the world, what their needs are, and how to structure the environment around them to support them better while curbing the experience of stress associated with excessive mentalizing.