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Minding the BodyMending the Mind

www.joanborysenko.com

Is the Paradigm Changing?

The ACE Study: Adverse Childhood Experiences

Bridges the Gap Between

Childhood Trauma and Negative Consequences Later in Life

Vincent F. Felitti, MD and Robert F. Anda, MD

www.ACEstudy.org

What is an ACE?

• Recurrent physical abuse

• Recurrent emotional abuse

• Contact sexual abuse

• Addiction in household

• Household member incarcerated

• Depressed, mentally ill, suicidal member

• One or no parents

• Mother treated violently

• Physical or emotional neglect

“Turning Gold into Lead”*

• Male child with ACE score of 6 has 4600% increase in probability of IV drug abuse

• ACE score of 4 increases probability of COPD by 390%

• ACE score of 4 or more raises the probability of depression almost 500%

• ACE score or 4 or more raises probability of suicide by 1220%

• *Felitti

ACE leads to Chronic Stress Through Negative Emotions

Anxiety

Depression

Hostility

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Telomeres are shorter in children who have been abused

AAAS Science. Photo Pasleka Photo Researchers

Stress Makes it Harder for the Body to Renew Itself

It shortens telomeres necessary for cell division and renewal, which causes an increase in cancer, depression, pulmonary fibrosis, dementia, osteoarthritis and osteoporosis. (Elizabeth Blackburn at UCSF)

Exercise protects telomeres!!!

Negative Emotions Immunity, Memory, Cardiac Function

•Increased fight or flight activity causes hypertension and damages the endothelium of blood vessels leading to atherosclerosis

•Cortisol depresses immune function and kills memory neurons in the hippocampus

•Stress increases production of IL‐6, a “pro‐inflammatory” cytokine.

•Inflammation contributes to heart disease, diabetes, arthritis, osteoporosis, many cancers and chronic illnesses, as well as the frailty of aging

•Stress inhibits DNA repair as well as cell longevity

HPA Axis

Negative Emotions and Proinflammatory Cytokines

• IL-6 overproduction results from both physical and emotional stress.

• Depression and anxiety increase IL-6 production.

• Inflammation is a commonality in heart disease, diabetes, osteoporosis, aging, some cancers and many chronic illnesses

Epigenetics:  Cellular Memory

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Unto Three or Four Generations What is Epigenetics?

The human genome is fairly constant and changes very slowly over millions of years. On the other hand, the environment around us changes all the time. A science called epigenetics explains how our genes can adapt to changes in the environment even though the actual structure of the genome‐ the genes themselves‐ don’t change.

The Coiling of DNA in Chromatin Methylation: The Off Switch

• Tightly coiled DNA is inaccessible for transcription, which means that the genes in that coil become silenced. Methyl molecules (CH3) attach to the histones and tighten the coils of DNA, blocking access to genes. 

• Each methylation is called a mark

Acetylation: The On Switch

• Acetyl (COCH3) molecules loosen the coils of DNA, exposing genes for transcription. 

• The sum total of epigenetic marks control your gene activity. Epigenetics technically means “above the genes” and that’s just what the marks represent‐ a control panel. The control panel is called the epigenome. 

Epigenetics and Bullying

•Identical Twins: The bullied twin had increased DNA methylation of SERT‐ a serotonin transporter gene

•The twin with increased SERT methylation had a decreased response to cortisol

•Decreased cortisol response is linked to poor stress coping strategies.

Louise Arsenault et al  

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How Do We Change Our View: Narrative, Brain, and Behavior?

Jill Bolte-Taylor, Ph.D. www.TED.com

Optimism and Pessimism:Attribution Theory and Coping

Suzanne Ouellette Kobasa

3 C’s of Stress Hardiness

•Challenge•Control•Commitment

“Stressful events challengeme to change and grow.”

Martin E.P. Seligman

3 P’s of Pessimism/Helplessness

•Personal•Pervasive•Permanent

“It’s my own fault, I mess up everything I do, and it’s the story of my life.”

Seven Mind-Body Modalities

• Exercise and Nutrition

• Meditation and Mindfulness

• Cognitive Restructuring

• Emotional Alchemy

• Gratitude

• Forgiveness

• Spirituality and Meaning

The Basics: Exercise and Nutrition Meditation and Mindfulness

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Siegel: Monitor and Modify the Information Flow

Emotional regulation requires:

1.Monitoring one’s affective state

2.Modifying the flow of energy “in a way that moves the system‐ body and relationships‐toward wellbeing.”

This is called integration, which leads to health.

Siegel’s Wheel of Awareness

An Essential Aspect of Mindfulness

“Mindfulness training can be hypothesized to change an individual’s relationship to his or her

emotions so that they are not viewed as fundamental constituents of self, but rather as more fleeting phenomena that appear to the

self.” –Richard Davidson, Ph.D.

The Guest House- RumiThis being human is a guest houseEvery morning a new arrival.A joy, a depression, a meanness,some momentary awareness comesas an unexpected visitor.Welcome and entertain them all!Even if they are a crowd of sorrows,who violently sweep your houseempty of its furniture,still treat each guest honorably.He may be clearing you out for some new delight.The dark thought, the shame, the malice,meet them at the door laughing,and invite them in.Be grateful for whoever comes,because each has been sentas a guide from beyond.

Approach and Integration

“People with mindful awareness training have a shift in their brains toward an “approach” state that allows them to move toward rather than away from challenging situations. This is the brain signature of resilience.”

‐Dan Siegel, MD

Brief Meditation Training

“Research suggests that (meditation) can change the brain very quickly and I’m always looking for the study that’s going to find the smallest dose! It’s easy to find studies showing that if you meditate for thousands of hours it changes the structure of the brain. We have a lot of studies like that, but some of the newer studies coming out are suggesting that we’re talking about 10 hours of meditation practice over a couple of weeks.” 

‐Kelly McGonigal, Ph.D.

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Gear Shift Breathing

• Like all meditation, yoga, qi gong, this marries the prefrontal cortex to the midbrain

• It increases Heart Rate Variability like other forms of focus and interval exercise

• It’s SUPER FAST. 1‐2 minutes of 4‐6 breaths per minute. Mindful breath in. Slow “ like through a straw” breath out.  

One Brain Two Minds

Midbrain: Instinctual, pleasure seeking, non-reflectivePrefrontal: Thinking, goal-oriented, reflective-“Does this choice help me realize my long-term goals and plans?”

Simple 5 Minute Meditations

• Ham Sah

• 4 to 1 countback

• Your choice. what is meaningful?

• Yoga breathing: many tpes

Gratitude: In the Moment and in mental reruns that strengthen resilience circuits

Daily Gratitude Exercises

• Increased alertness, enthusiasm, determination, attentiveness and energy

• Increased tendency to help others

• Greater sense of connection to others

• Better sleep

• Less stress

• More optimism which increases immune function

Weekly Gratitude Exercises

Those who keep weekly gratitude journalsexercise more regularly, report fewer physical symptoms, feel better about their lives, and are more optimistic about the coming week than those who write about neutral life events or hassles. They also make more progress toward goals in two-month follow-up.(Emmons and McCullough, 2003)

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Forgiveness: To turn and face the choice of holding on or letting go

Forgiveness and Health

Unforgiving persons have increased:•anxiety•paranoia•narcissism and callousness toward others•psychosomatic symptoms•heart disease•incidence of physical illness•depression

Forgiveness is for the Forgiver

• “Anger is like a hot coal you pick up to throw at somebody else, but it’s you who gets burned.” -The Buddha

• “Hatred is a banquet until you realize that you are the main course.”-Herbert Benson MD

• “Letting go of a grudge is a way to return to the peaceful center inside you.” -Frederic Luskin, Ph.D.; former director of the Stanford Forgiveness Project

Forgiveness Stats

• 94% of adults think that forgiveness is a good thing, but only 48% have tried it.

• The older we get the higher we score in forgiveness of others.

• Men prefer the terminology of letting go of grudges rather than forgiveness (Thoresen)

Forgiveness After Abuse

Emotionally abused women after relationship ends often have PTSD and affective disorders. 20 women were assigned to either forgiveness training or an alternative training in anger validation, assertiveness and interpersonal skill building.

Results

Women in the forgiveness intervention had significantly greater improvement in depression, trait anxiety, PTSD symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering.

Reed, GL et al Enright RD, J. Consult and Clin Psych, Oct 2006, 920-929.

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Spirituality and Meaning

Our birth is but a sleep and a forgetting, the soul that rises with us, our life’s star, hath elsewhere its setting and cometh from afar, not in entire forgetfulness and not in utter nakedness, but trailing clouds of glory do we come.

-Wordsworth

When it’s over, I want to say: all my lifeI was a bride married to amazement.I was the bridegroom, taking the world into my arms…I don’t want to end up simply having visited this world.

-Mary Oliver

When Death Comes