Bridgeway Rehabilitation Services, Inc

"When Hard Science Meets Psych Rehab”

Session 1: Introductory conceptsTuesday March 4, 2008

UMDNJ/SHRP, Scotch Plains, NJ

http://www.slideshare.net/johnfossella

Two people are standing on the edge of a fast-moving river. They spot someone being washed down the river. The first of the two people on the bank dives in to save the person; the second one just watches. More time passes, and another person is carried down the river. Again, the first person leaps in, while the second watches. This happens a third, then a fourth time. Finally, the first person yells at the second, “Why don’t you help?” And the second answers, “I’m trying to figure out why people keep falling into this river.”

The first person is a clinician, and the second is a scientist.

Goal of introductory session:

To make brain science more accessible and to relate the ways in which

YOUR clinical interventions "change the brain" leading to positive outcomes.

YOU are helping to repair and remediate brain circuits !

PART 1: Basic human brain anatomy

PART 2: What goes awry in mental illness ?

-late appearance of developmental deficits for attention-fear system and effects of stress

PART 3: The synapse and how we can “change the brain”

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“doing things in the scanner”is a way to get at

Where interventions target

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Take home message:

Your interventions may have engage specific neural circuits. This may be a

good thing and allow subjects to exercise specific circuits that are

functioning poorly.

We will try and get at these in subsequent sessions

PART 2: WHAT GOES AWRY IN MENTAL ILLNESS ?

Dr. David Lewis“developmental deficits

of attention and control systems”

Dr. Bruce McEwen“stress diathesis”

BLUE

RED

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GREEN

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Neuobiology of “Attention” is central

dorsolateral frontal cortex

http://www.tnp.pitt.edu/research/resframe_mb.htm

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Take home message:

Mental illness can have very deep biological roots. Even though many of the symptoms present in late adolescence, the biological

problems may have occurred before birth or during early childhood. One system of

particular vulnerability is the attention and control system.

over-active “fear” system & effects of stress

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amygdala

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chronic stress leads to vicious cycle of cognitive decline

Using cognition to turn off the amygdala

Take home message:

Mental illness also has an environmental aspect where the fear

and anxiety circuits are especially active leading to stress and cognitive

decline.

Care and sensitivity !

PART 3: Can we change the brain ?

Dr. Helen Mayberg

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Synapses

Take home message

There is much neuroscience showing that your care and intervention can

“change the brain” irrespective of and in conjunction with medication.

We have discussed some methods, and some basic anatomical systems (attention

and fear) as a foundation for our joint discussions on interventions and their

effects on brain systems.