Marin CAMFT, January 17, 2014 Linda Graham, MFT

Resilience and Well-Being Dealing with challenges and crises – The core of resilience and well-being Developing flexible strategies – The heart of therapeutic process

All the world is full of suffering. It is also full of overcoming. - Helen Keller

Effective Agents of Brain Change ConsciousnessSelf-Awareness MindfulnessSelf-Reflection CompassionEmpathy Attention Circuit Resonance Circuit Self-Directed Neuroplasticity

Therapeutic Modalities AEDPInternal Family SystemsEFT GestaltSensorimotor EMDRMBCTDBT PsychoanalyticExistential Control MasteryClient-centered JungianIntersubjective Object RelationsTranspersonal

The field of neuroscience is so new, we must be comfortable not only venturing into the unknown but into error. -Richard Mendius, M.D.

Neuroplasticity Growing new neurons Strengthening synaptic connections Myelinating pathways – faster connections Rebuilding brain structure Re-organizing functions of structures ….lifelong

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

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

Conditioning Experience causes neurons to fire Repeated experiences, repeated neural firings Neurons that fire together wire together Strengthen synaptic connections Connections stabilize into neural pathways Condtioning is neutral, wires positive and negative

It is not the strongest of the species that survives, Nor the most intelligent that survives. It is the one that is the most adaptive to change. - Charles Darwin

Attachment Styles Secure – safety and trust, stable and flexible, open to learning; flexible focus Insecure avoidant – mistrust of emotions and relationships, over-focus on self-world, rigid, neural cement Insecure-anxious – mistrust of self, over-focus on relationships, chaotic, neural swamp Disorganized – checked out, lack of focus

Secure attachment kindles maturation of the brain itself. Re-parenting in therapy recovers maturation of the brain itself.

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 experience Insight and self-knowing Response flexibility

Mechanisms of Brain Change New conditioning – focused attention Re-conditioning – juxtaposed attention De-conditioning – de-focused attention

New Conditioning Choose new experiences Create new learning, new memory Encode new wiring Install new patterns of response

Re-Conditioning “Light up” neural networks Juxtapose old negative with new positive De-consolidation – re-consolidation New rewires old

De-Conditioning De-focusing Loosens grip Create mental play space Plane of open possibilities New insight, new behaviors

Modes of Processing Focused Self-referential Tasks and details Constellate a representation New conditioning and Re-conditioning

Models of Processing De-focused Default network Fertile neural background noise Plane of open possibilities Mental play space De-conditioning

6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

Calm Serenity is not freedom from the storm but peace amidst the storm. -author unknown

Window of Tolerance SNS – fight-flight-freeze Baseline physiological equilibrium Calm and relaxed, engaged and alert WINDOW OF TOLERANCE Relational and resilient Equanimity PNS – numb out, collapse

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 stress hormon cortisol

Touch Hand on heart, hand on cheek Head rubs, foot rubs Massage back of neck Hugs – 20 second, full-bodied

Reconditioning through Soothing, Comforting, Caring Hand on the heart Progressive muscle relaxation Friendly body scan Movement opposite

Self-Compassion Break How am I doing? Is there any suffering here? Ouch! This hurts! Oh, sweetheart! Take one moment to be mindful and kind May I be safe from inner and outer harm. May I be free of suffering, from all causes of suffering, and from causing any suffering.

Clarity Mindfulness: focused attention on present moment experience without judgment or resistance. Jon Kabat-Zinn

Mindfulness and Psychotherapy Even-hovering attention Unconditional positive regard Observing ego What are you noticing now?

Mindfulness Pause, become present Notice and name Step back, dis-entangle, reflect Monitor and modify Shift perspectives Discern options Choose wisely

Between a stimulus and 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 circumstances. - Viktor Frankl

Notice and Name Thoughts as thoughts Patterns of thoughts as patterns of thoughts Feeling as feelings; cascades of feelings as cascades States of mind as state of mind Belief systems as belief systems All patterns of neural firing

Mindfulness Open, spacious awareness Open possibilities Epiphanies, insights, revelations True nature, essential goodness Inform, transform sense of personal self

Connections to Resources People Love guards the heart from the abyss - Mozart Places ….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 lives. - Buddha

Positive Emotions Help us feel and function better Put the brakes on negativity Antidote survival responses “Left shift” – open to experience Better coping with stress and trauma Possibilities, creativity, productivity Cooperation and collaboration Flexibility and resilience

Negativity Bias Right hemisphere Emotional-social processing Neuronally connected to lower brain Withdrawal, avoid stance toward experience Left hemispere Language and logic Less connected to lower brain Open, curious, approach stance toward experience Left Shift

Cultivate Gratitude 2 minute free write Gratitude journal Gratitude buddy Carry love and appreciation in your wallet

Positivity Portfolio Ask 10 friends to send cards Assemble phrases on piece of paoer Tape to bathroom mirror or computer monitor Carry in wallet or purse Read phrases 3 times a day for 30 days Savor and appreciate

Taking in the Good Notice: in the moment or in memory Enrich: the intensity, duration, novelty, personal relevance, multi-modality Absorb: savor seconds; felt sense in the body Repeat; persevere; little and often

Shame De-Rails Resilience Shame is the intensely painful feeling or experience of believing we are flawed and therefor unworhty of acceptance and belonging. Shame erodes the part of ourselves that believes we are capabel of change. We cannot change a nd grow when we are in shame, and we can’t use shame to change ourselves or others. - Brene Brown, PhD

Re-conditioning 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 resolution Hold new outcome in awareness, strengthening and refreshing Notice shift in perspective of experience, of self

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

Marin CAMFT Linda Graham, MFT