presentation as PowerPoint slides

Daniel Ellenberg, PhD
Linda Graham, MFT
Community Institute for Psychotherapy
October 19, 2013
All the world is full of suffering;
It is also full of overcoming.
- Helen Keller
Capacities innate in the brain
Hard-wired in by evolution
Learned in responses to experiences and
interactions encoded in neural circuitry
Kindles maturation of brain, especially prefrontal cortex – CEO of resilience
It is not the strongest of the species that
nor the most intelligent that survives.
It is the one that is the most adaptive to change.
- Charles Darwin
The field of neuroscience is so new,
We must be comfortable not only
Venturing into the unknown,
But into error.
- Richard Mendius, M.D.
 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 negative
 Growing new neurons
 Strengthening synaptic connections
 Myelinating pathways – faster processing
 Rebuilding brain structure
 Re-organizing functions of structures
 ….lifelong
 Evolutionary legacy
 Genetic loading
 Family of origin conditioning
 Norms-expectations of culture-society
 Who we are and how we cope…
 …is not out fault
Given neuroplasticity
and choices of self-directed neuroplasticity
Who we are and how we cope…
…is our responsibility
Self-directed neuroplasticity
Choosing new experiences to rewire for
Resilience and well-being
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 wholesome.
- Richard J. Davidson, PhD
Center for Investigating Healthy Minds
University of Wisconsin - Madison
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
 CEO of resilience
Functions of Pre-Frontal Cortex
 Regulate body and nervous system
 Quell fear response of the amygdala
 Manage emotions
 Attunement – tuning into feelings
 Empathy – making sense of experience
 Insight and self-knowing
 Response flexibility
Effective Agents of Brain Change
 Mindfulness (Attention Circuit)
 Empathy ( Resonance Circuit)
 Strengthen Pre-Frontal Cortex
 CEO of Resilience
Focused attention on
present moment experience
without judgment or resistance
 Pause, become present
 Notice and name
 Step back, dis-entangle, reflect
 Shift perspectives
 Discern options
 Choose wisely
Mindfulness and Psychotherapy
 Even-hovering attention
 Unconditional positive regard
 Observing ego
 “What are you noticing now?”
 Strengthens structure to see clearly
 Insula, anterior cingulate cortex, corpus
callosum, pre-frontal cortex
Resonance Circuit
 Resonance – brain stem
 Attunement – limbic system, insula, right
hemisphere, mirror neurons
 Empathy – frontal lobes
 Compassion – left hemisphere, motor cortex
 Self-Acceptance – whole brain
The roots of resilience are to be found in the
felt sense of existing in the heart and mind of
an empathic, attuned, self-possessed other.
- Diana Fosha, PhD
Mechanisms of Brain Change
 New conditioning
 Reconditioning
 Deconditioning
New Conditioning
 Choose new experiences
 Create new learning, new memory
 Encode new wiring
 Install new patterns of response
 “Light up” neural networks
 Juxtapose old negative with new positive
 De-consolidation – Re-consolidation
 New rewires old
 De-focusing
 Loosens grip
 Create mental play space
 Plane of open possibilities
 New insight, new behaviors
Modes of Processing
Tasks and details
Constellate a representation
New conditioning and
Modes of Processing
 Defocused
 Default network
 Fertile neural background noise
 Plane of open possibilities
 Mental play space
 Deconditioning
Five Practices to Accelerate
Brain Change
 Presence
 Intention
 Perseverance
 Refuges
 Resources
Six C’s of Coping
Connections to resources
Serenity is not freedom from the storm
but peace amidst the storm.
- author unknown
SNS – fight-flight-freeze
Relational and resilient
Calm and relaxed, engaged and alert
Baseline physiological equilibrium
PNS – appease, numb, collapse
CALM – Hand on the Heart
 Touch – oxytocin – safety and trust
 Deep breathing – parasympathetic
 Breathing ease into heart center
 Brakes on survival responses
 Coherent heart rate
 Being loved and cherished
 Oxytocin – direct and immediate antidote to cortisol
Reconditioning through
Soothing, Comforting, Caring
Hand on the Heart
Progressive Muscle Relaxation
Friendly Body Scan
 Respond to pain or suffering with an open heart, an
interested mind, and a natural willingness to help.
 Open to experience, activate care-giving, prime
ourselves to act.
 “Left shift” in brain – more neural activity in left
hemisphere – approach stance toward experience.
 Overcome negativity bias; become more optimistic,
more flexible, better resources, better able to find
Resonance Circuit
 Resonance – vibe, emotional contagion
 Outside of awareness
 Attunement – felt sense, explicit, non-verbal
 Empathy – verbal, cognition, coherent narrative
 Compassion – caring, concern, help
 Acceptance – pre-requisite for resilience
 Threat-protection system
 Cortisol driven
 Pleasure-reward system
 Dopamine driven
 Caregiving-soothing-comfort system
 Oxytocin system
 Paul Gilbert, The Compassionate Mind
 Notice this moment of suffering:
 “Ouch! This hurts.”
 What would be comforting here?
 What would be helpful
 Open to larger perspective:
 I’m not the only one; I’m not alone
Self-Compassion Break
 How am I doing?
 Is there any suffering here?
 How can I be mindful and compassionate in this
 May I be safe from inner and outer harm.
 May I be free of suffering, all causes of suffering, and
from causing any suffering.
Kindness is more important that wisdom,
and the recognition of that
is the beginning of wisdom.
- Theodore Rubin
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
 Relationships kindle maturation of pre-frontal cortex
 Re-parenting of therapy strengthens the PFC
 True Other to True Self
 Self-directed neuroplasticity
 Client strengthens their own pre-frontal cortex
Love makes your soul
Crawl out of its hiding place.
- Zora Neale Hurston
 Shame is the intensely painful feeling or experience of
believing we are flawed and therefor unworthy of
acceptance and belonging.
 Shame creates feelings of fear, blame, and disconnection
 We cannot change and grow when we are in shame, and
we can’t use shame to change ourselves or others.
 Shame erodes the part of ourselves that believes we are
capable of change.
 Shame: I am bad, flawed, unworthy, unfixable
 Guilt: I did something bad, regrettable; leads to healthy
remorse and amends
 Embarrassment: triggered by event that is normal,
fleeting, eventually even amusing
 Humiliation: recognition that event is unfair, undeserved
Shame Reslience
 1. Recognize shame triggers, shame identities, shame
 2. Contextualize – shame is not personal; it’s universal
and a psycho-social construct
 3. Reach out – share the story with someone who has
earned the right to hear it
 4. Speak the shame – ask for what is needed rather than
acting out or shutting down
Anchor in present moment awareness
Resource with acceptance and goodness
Start with small negative memory
“Light up the networks”
Evoke positive memory that contradicts or disconfirms
Juxtapose - simultaneous dual awareness (or toggle)
Refresh and strengthen positive
Let go of negative
Rest in, savor positive
Reflect on shifts in perspective
Wished For Outcome
 Evoke memory of what did happen
 Imagine new behaviors, new players, new resolution.
 Savor and strengthen
 Inner resources for reconditioning:
 Wiser Self
 Compassionate figure
 Inner resources
Resources for Clients
 Radical Acceptance by Tara Brach
 Self-Compassion by Kristin Neff
 The Gifts of Imperfection by Brene Brown
Connections to Resources
 People
 Love guards the heart from the abyss. - Mozart
 Place
 …I rest in the grace of the world….-Wendell Berry
 Practices
 As an irrigator guides water to his field, as an archer aims
an arrow, as a carpenter carves wood, the wise shape their
- Buddha
People as Resources
 Presence – dyadic regulation
 Circle of support
 Imagination powerful, portable
 Includes Wiser Self
 Deep listening
 Appreciation
 Positivity Portfolio
Positivity Portfolio
 Ask 10 friends to send cards
 Positive appreciations
 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
 Friendship and goodness
Places as Resources
 Safe place, refuge
 Nature – reset contraction
 Nature - expansiveness
Practices as Resources
 Paradigms – yoga, meditation, chi gong, prayer
 Movement – exercise
 Nutrition
 Sleep
 Laughter
 Learning
 Hang out with healthy brains
Positive Emotions
 Help us feel and function better
 Put the brakes on negativity
 Antidote survival responses
 Foster the left shift – open to experience
 Broaden possibilities in the moment
 Build resources long-term
 Build resilience
Positive Emotions Create:
 Better health and longevity
 Deeper social bonds
 Better coping with stress and trauma
 Creativity and productivity
 Confidence and cooperation
 Flexibility and resilience
Cultivate Gratitude
 2-minute free-write
 Gratitude journal
 Gratitude buddy
 Carry love and appreciation in your wallet
Taking in the Good
 Notice: in the moment or in memory
 Drop into felt sense in the body
 Savor 10-20-30 seconds
 Anchor in cue
Clarity - Mindfulness
 Pause, Become Present
 Notice and Name
 Step Back, Dis-Entangle, Reflect
 Shift Perspectives
 Discern Options
 Choose Wisely
Notice and Name
 Thoughts as thoughts; feelings as feelings
 Patterns of thoughts as patterns of thoughts
 States of mind as states of mind
 Identify belief systems and identities as:
 Mental contents; patterns of neural firing
 Strengthens pre-frontal cortex, anterior cingulate,
and insula
Shift Perspectives
 Switch the channel
 Monitor and modify
 Shift from victim “me” to empowered “I”
 Shift the entire neural network
Yes, risk-taking is inherently failure-prone.
Otherwise, it would be called sure-thing taking.
Tim McMahon
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
I am no longer afraid of storms,
for I am learning how to sail my ship.
- Louisa May Alcott
Daniel Ellenberg, PhD
[email protected]
Linda Graham, MFT
[email protected]

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