1. Bouncing Back Mind-Body Resources for Resilience and Well-Being Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net 415-924-7765

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

3. Factors of Resilience Hardiness Determination, grit, capacities to last, endure, to persevere and follow through Flexibility Adaptability, capacity to shift gears Coping Face and deal with disappointments, difficulties, even disasters

4. 6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

5. Calm Manage disruptive emotions Tolerate distress Down-regulate stress to return to baseline equilibrium

6. Compassion Respond to pain and suffering with open heart, interested mind, and willingness to help Keeps brain open to coping and learning

7. Clarity Focused attention on present moment experience See clearly what’s happening and reactions to what’s happening Improves cognitive functioning Self-awareness, self-reflection Shifting perspectives Discerning options Choose wise actions

8. Connections to Resources People, Places Practices Counter-balance brain’s negativity bias Strengthen inner secure base Access resources

9. Competence Empowerment and mastery from changing old coping strategies, learning new ones Embodying, “I am somebody who CAN do this.”

10. Courage Using signal anxiety as cue to: Try something new Take risks Move resilience beyond personal self

11. 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.

12. Neuroscience of Resilience Neuroscience technology is 20 years old Meditation improves attention and impulse control; shifts mood and perspective; promotes health Oxytocin can calm a panic attack in less than a minute Kindness and comfort, early on, protects against later stress, trauma, psychopathology

13. 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

14. 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

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

16. 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 Conditioning is neutral, wires positive and negative

17. Attachment Styles - Secure Parenting is attuned, empathic, responsive, comforting, soothing, helpful Attachment develops safety and trust, and inner secure base Stable and flexible focus and functioning Open to learning inner secure base provides buffer against stress, trauma, and psychopathology

18. Insecure-Avoidant Parenting is indifferent, neglectful, or critical, rejecting Attachment is compulsively self-reliant Stable, but not flexible Focus on self or world, not others or emotions Rigid, defensive, not open to learning Neural cement

19. Insecure-Anxious Parenting is inconsistent, unpredictable Attachment is compulsive caregiving Flexible, but not stable Focus on other, not on self-world, Less able to retain learning Neural swamp

20. Disorganized Parenting is frightening or abusive, or parent is “checked out,” not “there” Attachment is fright without solution Lack of focus Moments of dissociation Compartmentalization of trauma

21. Pre-Frontal Cortex Development kindled in relationships Executive center of higher brain Analysis, planning, judgment, impulse control Evolved most recently – makes us human Matures the latest – 25 years of age Most integrative structure of brain Evolutionary masterpiece CEO of resilience

22. 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 expereince Insight and self-knowing Response flexibility

23. 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

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

25. New Conditioning Choose new experiences Gratitude practice, listening skills, focusing attention, self-compassion, self-acceptance Create new learning, new memory Encode new wiring; install new pattern of response Antidote negativity bias, change ANTs to PATs, skills of emotional and relational intelligence

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

27. 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

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

29. Practices to Accelerate Brain Change Presence – primes receptivity of brain Intention/choice – activates plasticity Perseverance – creates and installs change

30. 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) Attention circuit and resonance circuit Two most powerful agents of brain change known to science; both foster response flexibility

31. Boundin’ video

32. 6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

33. Calm Manage disruptive emotions Tolerate distress Down-regulate stress to return to baseline equilibrium

34. 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

35. 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

36. 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

37. Calm through the Body Hand on the Heart Body Scan Progressive Muscle Relaxation Movement Opposite Power Posing

38. Compassion Respond to pain and suffering with open heart, interested mind, willingness to help Mindful Self-Compassion: Keep heart open and mind engaged when dealing with difficult events and difficult emotions that arise in response to events Practice not to feel better but because we feel bad

39. Self-Compassion Powerful and immediate antidote to self-criticism, self- loathing More effective in restoring well-being than self-esteem Practice not to feel better but because we feel bad Treat ourselves with care and understanding rather than harsh judgment Putting own oxygen mask on first when other people are not around Compassion leads to calm leads to clarity Emotional support needed for change and growth

40. Self-Compassion Break Notice-recognize: this is a moment of suffering Ouch! This hurts! This is hard! Pause, breathe, hand on heart or cheek Oh sweetheart! Self-empathy I care about my own suffering, me as experiencer Drop into calm; hold moment with awareness; breathe in compassion and care May I meet this moment fully; may I meet it as a friend

41. Self-Compassion Break, cont. My pain is the pain; I’m not the only one Kindness to self: May I be safe; May I be peaceful; May I be free of fear; May I be free of shame; May I accept myself just as I am; May I know this, too, will pass; May I know I can be skillful here Choose wisely: re-direct, shift the channel; practice gratitude, metta; share pain with caring other; notice coping and easing of suffering

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

43. Mindfulness Comes to the West Mindful schools Mindfulness Based Stress Reduction Business – 2014 World Economic Forum Government – Tim Ryan in Congress Military – post-traumatic stress Sports – peak performance Cover of Time magazine, February 3, 2014

44. Mindfulness Pause, become present Notice and name Step back, dis-entangle, reflect Catch the moment; make a choice Shift perspectives; shift states Discern options Choose wisely – let go of unwholesome, cultivate wholesome

45. Video – The Fly by Hanjin Song

46. 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

47. 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.

48. 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.

49. 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.

50. 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

51. Connections to Resources People Love guards the heart from the abyss. - Mozart Places …I rest in the grace of the world…. – 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

52. Positive Emotions-Behaviors 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

53. Positive Emotions Less stress, anxiety, depression, loneliness More friendships, social support, collaboration Shift in perspectives, more optimism More creativity, productivity Better health, better sleep Live on average 7-9 years longer Resilience is direct outcome

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

55. Take in the Good Notice: in the moment or in memory Enrich: the intensity, duration, novelty, personal relevance, multi-modality Absorb: savor 10-20-30 seconds, felt sense in body

56. 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

57. Positivity Portfolio Ask 10 friends to send cards or e-mails 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

58. True Other to the True Self 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 To see and be seen: that is the question, and that is the answer. - Ken Benau, PhD

59. Shame De-Rails Resilience 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

60. 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

61. 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

62. Relational Intelligence Setting limits and boundaries Negotiating change Resolving conflicts Repairing ruptures Forgiveness

63. Competence Empowerment and mastery from changing old coping strategies, learning new ones Embodying, “I am somebody who CAN do this.”

64. 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

65. 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.

66. Courage 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

67. 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

68. 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

69. Bouncing Back The Neuroscience of Resilience and Well-Being Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net 415-924-7765