Linda Graham, MFT Change Your Brain, Change Your Life : The Neuroscience of Well-Being New York Open Center October 24, 2015

Linda Graham, MFT Marriage and Family Therapist – 25 years Psychodynamic, Attachment, Trauma, Mindfulness, Neuroscience Bouncing Back: Rewiring Your Brain for Maximum Resilience and Well-Being 2013 Books for a Better Life award 2014 Better Books for a Better World award

There is a natural and inviolable tendency in things to bloom into whatever they truly are in the core of their being. All we have to do is align ourselves with what wants to happen naturally and put in the effort that is our part in helping it happen. - David Richo

Research about Well-Being Neuroscience Positive Psychology Emotional-Relational-Social Intelligence Trauma Therapy Mindfulness-Compassion Practice

Rewiring for Resilience and Well-Being Rewire brain out of stress-trauma-negativity- inner critic Recover resilience and resources – stability and flexibility Choose new experiences; harness neuroplasticity Move to thriving and flourishing

Kindness is more important than wisdom, And the recognition of that is the beginning of wisdom. - Theodore Rubin Doing a kindness produces the single most reliable momentary increase in well-being of any exercise we have tested. - Martin Seligman

Neuroscience of Kindness Fusiform gyrus Recognize faces Recognize facial expressions Perceive kindness, safety, openness, receptivity Down-regulate fear response of amygdala We regulate our nervous system by resonance of others

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

Human Brain: Evolutionary Masterpiece 100 billion neurons Each neuron contains the entire human genome Neurons “fire” hundreds of time per second Neurons connect to 5,000-7,000 other neurons Trillions of synaptic connections As many connections in single cubic centimeter of brain tissue as stars in Milky Way galaxy

Modern Brain Science 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 Greatest discovery of modern neuroscience Growing new neurons Strengthening synaptic connections Myelinating pathways – faster processing Creating and altering brain structure and circuitry Organizing and re-organizing functions of brain structures The brain changes itself - lifelong

Modern Neuroscience How neural structures/circuits develop How brain processes information; communicates within itself How brain learns/installs patterns of coping How brain rewires its memory patterns

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

Evolutionary legacy Genetic templates Family of origin conditioning Norms-expectations of culture-society Who we are and how we cope…. …is not our fault. - Paul Gilbert, The Compassionate Mind

Given neuroplasticity And choices of self-directed neuroplasticity Who we are and how we cope… …is our responsibility - Paul Gilbert, The Compassionate Mind

Response Flexibility 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

Response Flexibility 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, Austrian psychiatrist, survivor of Auschwitz

Response Flexibility How you respond to the issue…is the issue. - Frankie Perez, Momentous Institute

Functions of Pre-Frontal Cortex Center of executive functioning: judgment, planning, analysis, decision making Regulates body and nervous system Quells fear response of amygdala Manages emotions Attunement – felt sense of feelings Empathy – making sense of experience Insight and self-knowing Response flexibility CEO of Resilience

Mechanisms of Brain Change Conditioning New Conditioning Re-Conditioning De-Conditioning

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 Without intervention, is what the brain does Conditioning is neutral, wires positive and negative

New Conditioning Choose new experiences Focused attention, compassionate listening, gratitude practice Create new thoughts, new experience of self Create new learning, new memory Encode new wiring Install new pattern of response, new habits, new ways of being

Shift from Self-Critical Voice to Self-Compassionate Voice Loving awareness of breathing Let a moment of discomfort arise; notice where you feel in the body Notice any critical self-talk; notice the words; notice the tone of voice Use critical voice as cue to practice: “May I be kind to myself in this moment; may I accept myself in this moment exactly as I am.”

Re-conditioning Memory de-consolidation – re-consolidation “Light up” neural networks Juxtapose old negative with new positive Neurons fall apart, rewire New rewires old

Re-Conditioning Resource with memory of someone’s compassion toward you Evoke compassion for your self Evoke memory of someone being critical of you (or inner critic) Hold awareness of criticizing moment and compassionate moment in dual awareness Drop the criticizing moment; rest in the compassionate moment.

Modes of Processing Focused Attention Tasks and details Deliberate, guided change New conditioning and re-conditioning De-focused Attention Default network Mental play space – random change De-conditioning

De-Conditioning Default network De-focusing, loosens grip of attention Creates mental play space, free association Can drop into worry, rumination Can drop into plane of open possibilities Brain makes new links, associations New insights, aha!s new behaviors

De-Conditioning Reverie, daydreams Imagination Guided visualizations Guided meditations Brain “plays,” makes own associations and links, connect dots in new ways Reflect on new insights

Compassionate Friend Sit comfortably; hand on heart for loving awareness Imagine safe place Imagine warm, compassionate figure – Compassionate Friend Sit-walk-talk with compassionate friend Discuss difficulties; listen for exactly what you need to hear from compassionate friend Receive object of remembrance from friend Reflect-savor intuitive wisdom

Practices to Accelerate Brain Change Presence – primes receptivity of brain Intention/choice – activates plasticity Practice – creates new pathways, new more resilient habits of coping Perseverance – “little and often” installs change

Practices to Cultivate Well-Being Macro: vacation, gym, learn something new Micro: self-compassion break, 3-minute better-than-nothing-workout, hand on heart, notice and name

Intelligences Somatic:Body-based equilibrium Emotional: managing one’s own emotions and empathizing with others’; compassion Relational: connect, heal heartache, access resources, navigate peopled world Reflective: conscious awareness, mindfulness

Somatic Intelligence Regulate ANS – sympathetic and parasympathetic Reside in, expand window of tolerance Use body-based practices to shift mood, restore and expand brain functioning

Keep Calm and Carry On Serenity is not freedom from the storm but peace amidst the storm. - author unknown

Regulate Stress Macro Change conditions causing stress Job, boss, get family member into therapy Micro Work with brain to Manage disruptive emotions Tolerate distress Down-regulate stress

Window of Tolerance SNS – explore, play, create, produce…. OR Fight-flight-freeze Baseline physiological equilibrium Calm and relaxed, engaged and alert WINDOW OF TOLERANCE Relational and resilient Equanimity PNS – inner peace, serenity…. OR 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 hormone cortisol

Oxytocin Hormone of safety and trust, bonding and belonging, calm and connect Brain’s direct and immediate antidote to stress hormone cortisol Can pre-empt stress response altogether A single exposure to oxytocin can create a lifelong change in the brain. - Sue Carter, PhD

Touch Hand on heart, hand on cheek Head rubs, foot rubs Massage back of neck Hold thumb as “inner child” Hugs – 20 second full bodied

Calm through the Body Hand on the Heart Safe, soothing touch Body Scan Progressive Muscle Relaxation Soles of the Feet Rewiring through Movement Power Posing Mindful Self-Compassion

Calm – Friendly Body Scan Awareness Breathing gently into tension Hello! and gratitude Release tension, reduce trauma

Progressive Muscle Relaxation Body cannot be tense and relaxed at the same time Tense for 7 seconds, relax for 15 Focused attention calms the mind

Affectionate Breathing Sit comfortably; breathe slowly and gently. Incline your awareness toward your breathing with tenderness and curiosity Let the body breathe itself; notice the natural nourishing and soothing of the body Feel the whole body breathe Allow the body to be gently rocked by the breath Savor the stillness and peace in the body

Soles of the Feet Stand up; feel soles of feet on the floor Rock back and forth, rock side to side Make little circles with your knees Walk slowly; notice changes in sensations Offer gratitude to your feet that support your entire body, all day long

Rewiring through Movement Body inhabits posture of difficult emotion (40 seconds Body moves into opposite posture (40 seconds) Body returns to first posture (20 seconds) Body returns to second posture (20 seconds) Body finds posture in the middle (30 seconds Reflect on experience

Power Posing Amy Cuddy TED talk dy_language_shapes_who_you_are Before important meeting or interview: Stand tall and straight, like mountain pose in yoga Lift your arms in triumph or Place hands on hips (Wonder Woman)

Mindfulness and Compassion Awareness of what’s happening (and our reactions to what’s happening) Acceptance of what’s happening (and our reactions to what’s happening) Two most powerful agents of brain change known to science; both foster response flexibility Rewiring that is safe, efficient, effective

Mindfulness and Compassion Activate Caregiving System Mindfulness Focuses awareness on experience May I accept this moment, exactly as it is Self-Compassion Focuses kindness on experiencer May I accept myself exactly as I am in this moment Common Humanity I am not alone; I am not the only one Activates caregiving system Shift from reactivity and contraction to openness, engagement

Mindful Self-Compassion Shifts Brain Functioning In the present moment – restores equanimity Over time – creates new patterns of behavior Becomes way of being – natural, effortless

Benefits of Self-Compassion Increased motivation; efforts to learn and grow Less fear of failure; greater likelihood to try again Taking responsibility for mistakes; apologies and forgiveness More resilience in coping with life stressors Less depression, anxiety, stress, avoidance Healthier relationships; more support and, less control and/or aggression Increased social connectedness, life satisfaction, and happiness

Self-Compassion Break Notice moment of suffering Ouch! This hurts! This is painful. Soothing touch (hand on heart, cheek, hug) Kindness toward experiencer May I be kind to myself in this moment May I accept this moment exactly as it is May I accept myself in this moment exactly as I am May I give myself all the compassion I need to respond to this moment wisely

One for Me; One for You Breathing in, “nourishing, nourishing” Breathing out, “soothing, soothing” In imagination, “nourishing for me, nourishing for you, soothing for me, soothing for you” “One for me, one for you” Practice breathing “one for me, one for you” when in conversation with someone

Caregiving with Equanimity Everyone is on his or her own life journey. I am not the cause of this person’s suffering, nor is it entirely within my power to make it go away, even if I wish I could. Moments like this are difficult to bear, Yet I may still try to help if I can.

Emotional-social-relational Intelligence Experience, manage, express all emotions Attune, resonate with others’ emotions Empathy, compassion for self and other Theory of mind Trust self, others, relationships Use pro-social emotions to shift brain Open to learning and change

Neuroscience is Revolutionizing Our Thinking about Feelings Negative Emotions – Up Side of Your Dark Side Signal – pay attention, this is important! Motivator of action Positive Emotions – Positivity Antidotes negativity bias; Creates left shift; opens up possibilities Motivator of action Opens up possibilities

Emotions Signals to take action Adaptive action tendencies Anger – protest injustice, betrayal Sadness – pull in comfort Fear – move away from danger, toxicity Guilt – healthy remorse, make amends Joy – expand, connect with others

Negativity Bias - Positive Emotions Brain hard-wired to notice and remember negative and intense more than positive and subtle; how we survive as individuals and as a species Leads to tendency to avoid experience Positive emotions activate “left shift,” brain is more open to approaching experience, learning, and action

Positive Emotions GratitudeAweGenerosity CompassionDelight Serenity Love Curiosity Kindness Joy Trust

Practices of Positive Emotions Gratitude Take in the Good Circle of Support Positivity Portfolio

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

Take in the Good Notice: in the moment or in memory Enrich: the felt sense in the body Absorb: savor seconds, felt sense in body Repeat: 6 times a day, install in long-term memory

Circle of Support Call to mind people who have been supportive of you; who have “had your back” Currently, in the past, in imagination Imagine them gathered around you, or behind you, lending you their faith in you, and their strengths in coping Imagine your circle of support present with you as you face difficult people or situations

Positivity Portfolio Ask 10 friends to send cards or s expressing appreciation of you 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

Reflective Intelligence Catch the moment; make a choice - Janet Friedman Every moment has a choice; Every choice has an impact. - Julia Butterfly Hill

Mindfulness Focused attention on present moment experience without judgment or resistance. - Jon Kabat-Zinn

Mindfulness Pause, become present Notice and name Step back, dis-entangle, reflect Monitor and modify Shift perspectives; shift states Discern options Choose wisely – let go of unwholesome, cultivate wholesome

Notice and Name Increasingly complex objects of awareness: Sensations as sensations Emotions as emotions Cascades of emotions as cascades Thoughts as thoughts Patterns of thoughts as patterns States of mind as states of mind Identities, belief systems and identities as Mental contents, patterns of neural firing Awareness itself- a vast sky that clouds and storms pass through

Awareness of Reactions Imagine walking down the street Notice someone you know walking toward you Wave “hello!” There’s no response. Notice your response to the lack of response The person notices you and waves “hello!” Notice your response to the response Notice any differences in your responses

Mindfulness Dissolves the Stuff of “Self” Quantum physics investigates matter Matter is more space than stuff Mindfulness investigates “I” Self is not static or fixed; is ever-changing, ever-unfolding True Self is flow of beingness

Breathing into Infinity Anchor awareness in your breathing, and in the awareness that lets you know you’re breathing Expand awareness to include people near you, other people you know; people you don’t know in this town, region, country, all over the planet – all breathing, and the awareness that lets you know Expand awareness to include animals, plants, birds, fish. The earth itself: land, air, ocean – all breathing, and the awareness that holds it all Return to awareness of your breathing, in this moment and place, and of your awareness

Pre-Frontal Cortex Toggles back and forth between focused and defocused modes of processing Integration of two modes; integration of right and left hemispheres, integration of higher and lower brain Deeper brain functioning; brain itself more reslient

Autobiography in Five Short Chapters – Portia Nelson I I walk down the street. There is a deep hole in the sidewalk I fall in. I am lost…I am helpless It isn’t my fault. It takes me forever to find a way out.

II I walk down the same street. There is a deep hole in the sidewalk. I pretend I don’t see it. I fall in again. I can’t believe I’m in the same place But, it isn’t my fault. It still takes a long time to get out.

III I walk down the same street. There is a deep hole in the sidewalk. I see it is there. I still fall in…it’s a habit My eyes are open, I know where I am. It is my fault. I get out immediately.

IV I walk down the same street There is a deep hole in the sidewalk. I walk around it. V I walk down another street. -Portia Nelson

Relational Intelligence This is what our brains are wired for: reaching out to and interacting with others. These are design features, not flaws. These social adaptations are central to making us the most successful species on earth. - Matthew Lieberman, PhD Social: Why Our Brains Are Wired To Connect

Connections Increasing the social connections in our lives is probably the single easiest way to enhance our well-being. - Matthew Lieberman, UCLA The roots of resilience are to be found in the felt sense of being held in the mind and heart of an empathic, attuned, and self-possessed other. - Diana Fosha, PhD

Shame De-Rails Well-Being Shame 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 can’t use shame to change ourselves or others. - Brene Brown, PhD

Just that action of paying attention to ourselves, that I care enough about myself, that I am worthy enough to pay attention to, starts to unlock some of those deep beliefs of unworthiness at a deeper level in the brain. - Elisha Goldstein

Reconditioning 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

Reconditioning 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 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 Hold new outcome in awareness, strengthening and refreshing Notice shift in perspective of experience, of self

Competence Embodied sense, “Sure I can!” From previous competence, no matter how small Ownership Empowerment and mastery from changing old coping strategies, learning new ones Embodying, “I am somebody who CAN do this.” You can’t stop the waves, but you can learn to surf. - Jon Kabat-Zinn

Post-Traumatic Growth Acceptance of reality; create the new narrative Support from family; belief in recovery Community of “the tribe” Positive re-framing; positive meaning of negative event Helping others Appreciate new life because of catastrophe

Find the Gift in the Mistake Regrettable Moment – Teachable Moment What’s Right with this Wrong? What’s the Lesson? What’s the Cue to Act Differently? Find the Gift in the Mistake

Coherent Narrative This is what happened. This is what I did. This has been the cost. This is what I learned. This is what I would do differently going forward.

I am no longer afraid of storms, For I am learning how to sail my ship. - Louisa May Alcott

Courage It’s as wrong to deny the possible As it is to deny the problem. - Dennis Seleeby A ship is safe in harbor, but that’s not what ships are for. - Grace Hopper 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

How to Replenish Human Brain Exercise-Movement Sleep - Rest Nutrition Laughter-Play Learn Something New Hang Out with Healthy Brains

Exercise - Movement Cardio: What’s good for the heart is good for the brain BDNF – grow new neurons Yoga, qi gong – move the energy 3-minute better than nothing workout Move your body once every hour Sense and savor walk

Sleep - Rest 8 hours every night Consolidate learning Housekeeping Circadian rhythm governs body’s major systems Micro practices Take a nap – 20 minutes between 2pm-4pm Mini-meditate (10 breaths) Take mental breaks; switch the channel

Take Mental Breaks Focus on something else (positive is good) Talk to someone else (resonant is good) Move-walk somewhere else (nature is good) Every 90 minutes; avoid adrenal fatigue

Nutrition Eat healthy! More protein, more plants, more water less sugar, less carbs, less calories, less caffeine/alcohol Savor (eat a raisin meditation) Eat one meal a day without doing anything else

Laughter-Play Reset the nervous system; open the brain to learning and creativity Have a good time at family/friends dinner/celebration Schedule a play date Schedule a silly date

Learn Something New Macro Speak a foreign language Play a musical instrument Juggle Play chess Micro Learn a new poem, quote, flower, bird each day

There is a natural and inviolable tendency in things to bloom into whatever they truly are in the core of their being. All we have to do is align ourselves with what wants to happen naturally and put in the effort that is our part in helping it happen. - David Richo

Linda Graham, MFT Change Your Brain, Change Your Life : The Neuroscience of Well-Being New York Open Center October 24, 2015