Transcript Slide 1

Psychotherapy Networker
2014 Symposium
March 20, 2014
Washington, D.C.
Linda Graham, MFT
[email protected]
Bouncing Back: Rewiring Your Brain
For Maximum Resilience and Well-Being
I arise in the morning
Torn between the desire
To save the world
And a desire to savor the world.
This makes it hard to plan the day.
- E.B. White
Self Care: Antidote to Compassion Fatigue
 Overwhelm of care for others
 Self-care drops off the radar
 Clinicians are vehicles for concern and care
 Self-care: replenish and resource self
 Energy and bandwidth to care for others
Neuroscience of Self-Care
 Neuroscience technology is 20 years old
 Meditation shifts mood and perspective;
impacts immune system and gene expression
 Oxytocin can calm a panic attack in less than a
 Kindness and comfort, early on, protects
against later stress, trauma, psychopathology
Human Brain:
Evolutionary Masterpiece
 100 billion neurons
 Each neuron contains the entire human genome
 Neurons “fire” hundreds of time per second
 Neurons connect to 5,000-7,000 other neurons
 Trillions of synaptic connections
 As many connections in single cubic centimeter of
brain tissue as stars in Milky Way galaxy
The field of neuroscience is so new,
we must be comfortable not only
venturing into the unknown
but into error.
- Richard Mendius, M.D.
 Growing new neurons
 Strengthening synaptic connections
 Myelinating pathways – faster processing
 Creating and altering brain structure and
 Organizing and re-organizing functions of brain
 Experience causes neurons to fire
 Repeated experiences, repeated neural firings
 Neurons that fire together wire together
 Strengthen synaptic connections
 Connections stabilize into neural pathways
 Conditioning is neutral, wires positive and
The brain is shaped by experience. And because
we have a choice about what experiences we
want to use to shape our brain, we have a
responsibility to choose the experiences that
will shape the brain toward the wise and the
- Richard J. Davidson, PhD
Evolutionary legacy
Genetic templates
Family of origin conditioning
Norms-expectations of culture-society
Who we are and how we cope….
…is not our fault.
 Given neuroplasticity
 And choices of self-directed neuroplasticity
 Who we are and how we cope…
 …is our responsibility
Between a stimulus and a response there is a
space. In that space is our power to choose
our response. In our response lies our growth
and our freedom. The last of human freedoms
is to choose one’s attitude in any given set of
- Viktor Frankl, Austrian psychiatrist, survivor
of Auschwitz
7 R’s of Self-Care
 Replenish
 Recognize
 Regulate
 Reflect
 Resource
 Re-Frame
 Re-Wire
 Deal with challenges and crises
 Bounce back from adversity
 Recover our balance and equilibrium
 Find refuges and maximize resources
 Cope skillfully, flexibly, adaptively
 Shift perspectives, open to possibilities, create
options, find meaning and purpose
 Sleep
 Nutrition
 Movement-Exercise
 Laughter
 Hanging Out with Healthy Brains
 Housekeeping
 Reset nervous system
 Consolidate learning
 Take mental breaks
How to Sleep Well
 Stick to a sleep schedule
 Pay attention to what you eat and drink
 Create a bedtime ritual
 Get comfortable
 Limit daytime naps
 Include physical activity in your daily routine
 Manage stress
Take Mental Breaks
 Focus on something else (positive is good)
 Talk to someone else (resonant is good)
 Move-walk somewhere else (nature is good)
 Avoid adrenal fatigue
 Less Caffeine
 Less Sugar
 More Protein
Movement - Exercise
 Oxygen – brain is 2% of body weight, uses 20%
of body’s oxygen
 Endorphins – feel good hormones, brighten
the mind
 Brain-Derived Neurotrophic Factor (BDNF) grow new brain cells, will migrate to where
 Increases oxygen and blood flow, reduces risk of
heart disease and stroke
 Releases endorphins – body’s natural pain killer
 Reduces stress hormone cortisol, lowers blood
 Triggers catecholamines, heightens alertness in
 Releases tension in body, balances nervous
 Promotes work productivity
 Reduces stress
 Promotes creativity and problem-solving
 Reduces mistakes, increases efficiency
Promotes group cohesion
 Promotes learning (through play)
 Eases loss, grief, trauma
How to Promote Laughter
 Humor
 A person without a sense of humor is like a wagon
without springs – jolted by every pebble in the
road. - Henry Ward Beecher
 Play
 Play, in short, prepares the brain to handle the
unexpected. – Lee Alan Dugatkin
 Playful resonance
 Laughter is the closest distance between two
people. – Victor Borge
Hanging Out with Healthy Brains
 Brain is social organ; matures and learns best
in interactions with other brains
 Social engagement regulates nervous system
 Resonant interactions prime the brain’s
neuroplasticity; promotes learning and growth
Focused attention on
present moment experience
without judgment or resistance.
- Jon Kabat-Zinn
Attention and allowing
Awareness and acceptance
Mindful Self-Compassion
 Awareness of what’s happening
 (and our reaction to what’s happening)
 Acceptance of what’s happening
 (and acceptance of our reaction)
 Brain stays plastic, open to learning
Self-Compassion Break
 Notice-recognize: this is a moment of suffering
 Ouch! This hurts! This is hard!
 Pause, breathe, hand on heart or cheek
 Oh sweetheart!
 Self-empathy
 Of course this is painful, and I’m not the only one; I’m
not alone
 Drop into calm; hold moment with awareness; breathe
in compassion and care
 May I be free of suffering and the causes of suffering
 Share experience with resonant other
Regulate: Keep Calm and Carry On
Serenity is not freedom from the storm
but peace amidst the storm.
- author unknown
 Hormone of safety and trust, bonding and
belonging, calm and connect
 Brain’s direct and immediate antidote to stress
hormone cortisol
 Can pre-empt stress response altogether
Hand on the Heart
 Touch
 Deep breathing
 Positive Emotions
 Brakes on survival responses
 Oxytocin – safety and trust
 Relationships as resources
Window of Tolerance
 SNS – explore, play, create, produce…. OR
Baseline physiological equilibrium
Calm and relaxed, engaged and alert
Relational and resilient
 PNS – inner peace, serenity…. OR
Numb out, collapse
Mindfulness and Psychotherapy
 Even-hovering attention
 Unconditional positive regard
 Observing ego
 “What are you noticing now?”
 Pause, become present
 Notice and name
 Step back, dis-entangle, reflect
 Catch the moment; make a choice
 Shift perspectives; shift states
 Discern options
 Choose wisely – let go of unwholesome,
cultivate wholesome
 Practices
 Places
 People
Positive Emotions-Behaviors
 Brain hard-wired to notice and remember
negative and intense more than positive and
subtle; how we survive as individuals and as a
 Leads to tendency to avoid experience
 Positive emotions activate “left shift,” brain is
more open to approaching experience,
learning, and action
Positive Emotions
Positive Emotions
 Help us feel and function better
 Put the brakes on negativity
 Antidote survival responses
 Foster the left shift, open to experience
 Better coping with stress and trauma
 Possibilities, creativity, productivity
 Cooperation and collaboration
 Flexibility and resilience
Kindness is more important than wisdom,
And the recognition of that is the beginning of
- Theodore Rubin
Neuroscience of Sharing Positive
 Social engagement system
 Dyadic regulation
 Vagal brake
 Fusiform gyrus regulates amygdala
 Emotional communication is 93% non-verbal
 Restores equilibrium
 2-minute free write
 Gratitude journal
 Gratitude buddy
 Carry love and appreciation in your wallet
Positivity Portfolio
 Ask 10 friends to send cards or e-mails
expressing appreciation of you
 Assemble phrases on piece of paper
 Tape to bathroom mirror or computer monitor,
carry in wallet or purse
 Read phrases 3 times a day for 30 days
 Savor and appreciate
Take in the Good
 Notice: in the moment or in memory
 Enrich: the intensity, duration, novelty,
personal relevance, multi-modality
 Absorb: savor 10-20-30 seconds, felt sense in
Places as Resources
 Nature as refuge – re-Source
 Nature is our biology, our being
 We can create and notice shifts in perspective
People as Resources
At times our own light goes out and is rekindled
by the spark from another person.
Each of us has cause to think with deep
gratitude of those who have lighted the flame
within us.
- Albert Schweitzer
Attachment Styles
 Secure –safety and trust, stable and flexible focus
and functioning, open to learning, inner secure
base provides buffer against stress, trauma
 Insecure-avoidant – stable, not flexible, focus on
self-world, not on other or emotions, rigid,
defensive, not open to learning, neural cement
 Insecure-anxious – flexible, not stable, focus on
other, not on self-world, less able to retain
learning, neural swamp
 Disorganized – lack of focus, moments of
dissociation, compartmentalization of trauma
Pre-Frontal Cortex
 Executive center of higher brain
 Evolved most recently – makes us human
 Development kindled in relationships
 Matures the latest – 25 years of age
 Evolutionary masterpiece
 CEO of resilience
Functions of Pre-Frontal Cortex
 Regulate body and nervous system
 Quell fear response of amygdala
 Manage emotions
 Attunement – felt sense of feelings
 Empathy – making sense of expereince
 Insight and self-knowing
 Response flexibility
I have learned that people
will forget what you said
and people will forget what you did,
but people will never forget
how you made them feel.
- Maya Angelou
Resonance Circuit
 Resonance – vibe, emotional contagion
 Attunement – felt sense, explicit, non-verbal
 Empathy – verbal, cognitive, coherent
 Compassion – concern, caring, help
 Acceptance – pre-requisite for resilience and
lasting change
The roots of resilience are to be found in the felt
sense of being held in the heart and mind of an
empathic, attuned, and self-possessed other.
- Diana Fosha, PhD
Shame De-Rails Resilience
Shame is the intensely painful feeling or
experience of believing we are flawed and
therefore unworthy of acceptance and
Shame erodes the part of ourselves that
believes we are capable of change. We cannot
change and grow when we are in shame, and
we can’t use shame to change ourselves or
Love makes your soul crawl out of its hiding
- Zora Neale Hurston
Love guards the heart from the abyss.
- Mozart
Seeing Ourselves as Others See Us
 Imagine sitting across from someone who
loves you unconditionally
 Imagine switching places with them; see
yourself as they see you; feel why they love
you and delight in you; take in the good
 Imagine being yourself again; taking in the love
and affection coming to you; savor and absorb.
 Memory de-consolidation – re-consolidation
 “Light up” neural networks of problematic memory
 Cause neural networks to fall apart temporarily and
instantly rewire by:
 Juxtaposing positive memory that directly contradicts
or disconfirms;
 Focused attention on juxtaposition of both memories
held in simultaneous dual awareness
 Causes the falling apart and the rewiring
Wished for Outcome
 Evoke memory of what did happen
 Imagine new behaviors, new players, new
 Hold new outcome in awareness,
strengthening and refreshing
 Notice shift in perspective of experience, of
Relational Intelligence
 Setting limits and boundaries
 Negotiating change
 Resolving conflicts
 Repairing ruptures
 Forgiveness
Forgiveness - I
For the many ways that I have hurt and harmed
myself, that I have betrayed or abandoned
myself, out of fear, pain, and confusion,
through action or inaction, in thought, word or
deed, knowingly or unknowingly…
I extend a full and heartfelt forgiveness. I
forgive myself. I forgive myself.
Forgiveness - II
For the ways that I have hurt and harmed you,
have betrayed or abandoned you, caused you
suffering, knowingly or unknowingly, out of my
pain, fear, anger, and confusion…
I ask for your forgiveness, I ask for your
Forgiveness - III
For the many ways that others have hurt,
wounded, or harmed me, out of fear, pain,
confusion, and anger…
I have carried this pain in my heart long enough.
To the extent that I am ready, I offer you
forgiveness. To those who have caused me
harm, I offer my forgiveness, I forgive you.
 Regrettable Moment – Teachable Moment
 What’s Right with this Wrong?
 What’s the Lesson?
 What’s the Cue to Act Differently?
 Find the Gift in the Mistake
Coherent Narrative
 This is what happened.
 This is what I did.
 This has been the cost.
 This is what I’ve learned.
 This is what I would do differently going
Mechanisms of Brain Change
 Conditioning
 New Conditioning
 Re-Conditioning
 De-Conditioning
New Conditioning
 Choose new experiences
 Positive emotions, resonant relationships, selfcompassion, self-acceptance
 Create new learning, new memory
 Encode new wiring
 Install new pattern of response
 “Light up” neural networks
 Juxtapose old negative with new positive
 De-consolidation - re-consolidation
 New rewires old
Do One Scary Thing a Day
 Venture into New or Unknown
 Somatic marker of “Uh, oh”
 Dopamine disrupted
 Cross threshold into new
 Satisfaction, mastery
 Dopamine restored
 De-focusing
 Loosens grip
 Creates mental play space
 Plane of open possibilities
 New insights, new behaviors
Brahma Viharas
 Loving Kindness
 Compassion
 Sympathetic Joy
 Equanimity
Modes of Processing
 Focused
 Tasks and details
 Self-referential
 New conditioning and re-conditioning
 De-focused
 Default network
 Fertile neural background noise
 De-conditioning
Practices to Accelerate Brain Change
 Presence – primes receptivity of brain
 Intention/choice – activates plasticity
 Perseverance – creates and installs change
I am no longer afraid of storms,
For I am learning how to sail my ship.
- Louisa May Alcott
Linda Graham, MFT
[email protected]