Slide 1

Brain Care is Self-Care

Psychotherapy Networker2014 SymposiumMarch 20, 2014Washington, D.C.Brain Care is Self-Care

Linda Graham, MFTwww.lindagraham-mft.netlindagraham2@earthlink.netBouncing Back: Rewiring Your BrainFor Maximum Resilience and Well-BeingI arise in the morningTorn between the desireTo save the worldAnd a desire to savor the world.This makes it hard to plan the day.- E.B. WhiteSelf Care: Antidote to Compassion FatigueOverwhelm of care for othersSelf-care drops off the radarClinicians are vehicles for concern and careSelf-care: replenish and resource selfEnergy and bandwidth to care for othersNeuroscience of Self-CareNeuroscience technology is 20 years old

Meditation shifts mood and perspective; impacts immune system and gene expressionOxytocin can calm a panic attack in less than a minuteKindness and comfort, early on, protects against later stress, trauma, psychopathologyHuman Brain:Evolutionary Masterpiece100 billion neuronsEach neuron contains the entire human genomeNeurons fire hundreds of time per secondNeurons connect to 5,000-7,000 other neuronsTrillions of synaptic connectionsAs many connections in single cubic centimeter of brain tissue as stars in Milky Way galaxyThe field of neuroscience is so new,we must be comfortable not only venturing into the unknownbut into error.- Richard Mendius, M.D. NeuroplasticityGrowing new neuronsStrengthening synaptic connectionsMyelinating pathways faster processingCreating and altering brain structure and circuitryOrganizing and re-organizing functions of brain structuresConditioningExperience causes neurons to fireRepeated experiences, repeated neural firingsNeurons that fire together wire togetherStrengthen synaptic connectionsConnections stabilize into neural pathways

Conditioning is neutral, wires positive and negativeThe 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 wholesome.- Richard J. Davidson, PhDEvolutionary legacyGenetic templatesFamily of origin conditioningNorms-expectations of culture-society

Who we are and how we cope.is not our fault.Given neuroplasticityAnd choices of self-directed neuroplasticity

Who we are and how we copeis our responsibilityBetween 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 ones attitude in any given set of circumstances.- Viktor Frankl, Austrian psychiatrist, survivor of Auschwitz7 Rs of Self-CareReplenishRecognizeRegulateReflectResourceRe-FrameRe-Wire

ResilienceDeal with challenges and crisesBounce back from adversityRecover our balance and equilibriumFind refuges and maximize resourcesCope skillfully, flexibly, adaptivelyShift perspectives, open to possibilities, create options, find meaning and purposeReplenishSleepNutritionMovement-ExerciseLaughterHanging Out with Healthy BrainsSleepHousekeepingReset nervous systemConsolidate learning

Take mental breaksHow to Sleep WellStick to a sleep schedulePay attention to what you eat and drinkCreate a bedtime ritualGet comfortableLimit daytime napsInclude physical activity in your daily routineManage stressTake Mental BreaksFocus on something else (positive is good)

Talk to someone else (resonant is good)

Move-walk somewhere else (nature is good)

Avoid adrenal fatigue

NutritionLess Caffeine

Less Sugar

More Protein

Movement - ExerciseOxygen brain is 2% of body weight, uses 20% of bodys oxygenEndorphins feel good hormones, brighten the mindBrain-Derived Neurotrophic Factor (BDNF) - grow new brain cells, will migrate to where neededLaughterIncreases oxygen and blood flow, reduces risk of heart disease and strokeReleases endorphins bodys natural pain killerReduces stress hormone cortisol, lowers blood pressureTriggers catecholamines, heightens alertness in brainReleases tension in body, balances nervous systemLaughterPromotes work productivityReduces stressPromotes creativity and problem-solvingReduces mistakes, increases efficiency Promotes group cohesionPromotes learning (through play)Eases loss, grief, traumaHow to Promote LaughterHumorA person without a sense of humor is like a wagon without springs jolted by every pebble in the road. - Henry Ward BeecherPlayPlay, in short, prepares the brain to handle the unexpected. Lee Alan DugatkinPlayful resonanceLaughter is the closest distance between two people. Victor BorgeHanging Out with Healthy BrainsBrain is social organ; matures and learns best in interactions with other brainsSocial engagement regulates nervous systemResonant interactions prime the brains neuroplasticity; promotes learning and growthRecognize Mindfulness: Focused attention onpresent moment experiencewithout judgment or resistance.- Jon Kabat-Zinn

Attention and allowingAwareness and acceptanceMindful Self-CompassionAwareness of whats happening (and our reaction to whats happening)Acceptance of whats happening(and acceptance of our reaction)

Brain stays plastic, open to learningSelf-Compassion BreakNotice-recognize: this is a moment of sufferingOuch! This hurts! This is hard!Pause, breathe, hand on heart or cheekOh sweetheart!Self-empathyOf course this is painful, and Im not the only one; Im not aloneDrop into calm; hold moment with awareness; breathe in compassion and careMay I be free of suffering and the causes of sufferingShare experience with resonant otherRegulate: Keep Calm and Carry OnSerenity is not freedom from the storm

but peace amidst the storm.

- author unknownOxytocinHormone of safety and trust, bonding and belonging, calm and connectBrains direct and immediate antidote to stress hormone cortisolCan pre-empt stress response altogetherHand on the HeartTouch Deep breathingPositive EmotionsBrakes on survival responsesOxytocin safety and trustRelationships as resourcesWindow of ToleranceSNS explore, play, create, produce. ORFight-flight-freeze

Baseline physiological equilibriumCalm and relaxed, engaged and alertWINDOW OF TOLERANCERelational and resilientEquanimity

PNS inner peace, serenity. ORNumb out, collapseReflectMindfulness and Psychotherapy

Even-hovering attentionUnconditional positive regardObserving egoWhat are you noticing now?MindfulnessPause, become presentNotice and nameStep back, dis-entangle, reflectCatch the moment; make a choiceShift perspectives; shift statesDiscern optionsChoose wisely let go of unwholesome, cultivate wholesomeResourcePractices

Places

PeoplePositive Emotions-BehaviorsBrain hard-wired to notice and remember negative and intense more than positive and subtle; how we survive as individuals and as a speciesLeads to tendency to avoid experiencePositive emotions activate left shift, brain is more open to approaching experience, learning, and actionPositive EmotionsGratitudeAweGenerosity CompassionDelight Serenity Love Curiosity Kindness Joy TrustPositive EmotionsHelp us feel and function betterPut the brakes on negativityAntidote survival responsesFoster the left shift, open to experienceBetter coping with stress and traumaPossibilities, creativity, productivityCooperation and collaborationFlexibility and resilienceKindness is more important than wisdom,And the recognition of that is the beginning of wisdom.- Theodore RubinNeuroscience of Sharing Positive EmotionsSocial engagement systemDyadic regulationVagal brakeFusiform gyrus regulates amygdalaEmotional communication is 93% non-verbalRestores equilibriumGratitude2-minute free writeGratitude journalGratitude buddyCarry love and appreciation in your walletPositivity PortfolioAsk 10 friends to send cards or e-mails expressing appreciation of youAssemble phrases on piece of paperTape to bathroom mirror or computer monitor, carry in wallet or purseRead phrases 3 times a day for 30 daysSavor and appreciateTake in the GoodNotice: in the moment or in memoryEnrich: the intensity, duration, novelty, personal relevance, multi-modalityAbsorb: savor 10-20-30 seconds, felt sense in bodyPlaces as ResourcesNature as refuge re-Source

Nature is our biology, our being

We can create and notice shifts in perspectivePeople as ResourcesAt 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 SchweitzerAttachment StylesSecure safety and trust, stable and flexible focus and functioning, open to learning, inner secure base provides buffer against stress, traumaInsecure-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 swampDisorganized lack of focus, moments of dissociation, compartmentalization of traumaPre-Frontal CortexExecutive center of higher brainEvolved most recently makes us humanDevelopment kindled in relationshipsMatures the latest 25 years of ageEvolutionary masterpiece

CEO of resilienceFunctions of Pre-Frontal CortexRegulate body and nervous systemQuell fear response of amygdalaManage emotionsAttunement felt sense of feelingsEmpathy making sense of expereinceInsight and self-knowingResponse flexibilityI have learned that peoplewill forget what you saidand people will forget what you did,but people will never forgethow you made them feel.- Maya AngelouResonance CircuitResonance vibe, emotional contagionAttunement felt sense, explicit, non-verbalEmpathy verbal, cognitive, coherent narrativeCompassion concern, caring, helpAcceptance pre-requisite for resilience and lasting changeThe 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, PhDShame De-Rails ResilienceShame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging.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 cant use shame to change ourselves or others.Love makes your soul crawl out of its hiding place.- Zora Neale Hurston

Love guards the heart from the abyss.- MozartSeeing Ourselves as Others See UsImagine sitting across from someone who loves you unconditionallyImagine switching places with them; see yourself as they see you; feel why they love you and delight in you; take in the goodImagine being yourself again; taking in the love and affection coming to you; savor and absorb.ReconditioningMemory de-consolidation re-consolidationLight up neural networks of problematic memoryCause 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 awarenessCauses the falling apart and the rewiring

Wished for OutcomeEvoke memory of what did happenImagine new behaviors, new players, new resolutionHold new outcome in awareness, strengthening and refreshingNotice shift in perspective of experience, of selfRelational IntelligenceSetting limits and boundariesNegotiating changeResolving conflictsRepairing rupturesForgiveness Forgiveness - IFor 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 unknowinglyI extend a full and heartfelt forgiveness. I forgive myself. I forgive myself.Forgiveness - IIFor 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 confusionI ask for your forgiveness, I ask for your forgiveness.Forgiveness - IIIFor the many ways that others have hurt, wounded, or harmed me, out of fear, pain, confusion, and angerI 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.Re-frameRegrettable Moment Teachable MomentWhats Right with this Wrong?Whats the Lesson?Whats the Cue to Act Differently?Find the Gift in the MistakeCoherent NarrativeThis is what happened.This is what I did.This has been the cost.This is what Ive learned.This is what I would do differently going forwardMechanisms of Brain ChangeConditioningNew ConditioningRe-ConditioningDe-ConditioningNew ConditioningChoose new experiencesPositive emotions, resonant relationships, self-compassion, self-acceptanceCreate new learning, new memoryEncode new wiringInstall new pattern of responseRe-conditioningLight up neural networksJuxtapose old negative with new positiveDe-consolidation - re-consolidationNew rewires oldDo One Scary Thing a DayVenture into New or UnknownSomatic marker of Uh, ohDopamine disruptedCross threshold into newSatisfaction, masteryDopamine restoredDe-ConditioningDe-focusingLoosens gripCreates mental play spacePlane of open possibilitiesNew insights, new behaviors

Brahma ViharasLoving KindnessCompassionSympathetic JoyEquanimityModes of ProcessingFocusedTasks and detailsSelf-referentialNew conditioning and re-conditioningDe-focusedDefault networkFertile neural background noiseDe-conditioningPractices to Accelerate Brain ChangePresence primes receptivity of brain

Intention/choice activates plasticity

Perseverance creates and installs changeI am no longer afraid of storms,For I am learning how to sail my ship.- Louisa May AlcottBrain Care is Self-Care

Linda Graham, MFTwww.lindagraham-mft.netlindagraham2@earthlink.net