1. Bouncing Back: The Neuroscience of Resilience and Well-Being San Leandro Public Library July 10, 2014

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

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

4. Suffering External stressors Internal stressors Stress response Survival responses Fight-flight-freeze-appease Shut down, numb out, collapse

5. Resilience Hardiness Coping Flexibility

6. Hardiness Capacities to last, to endure Capacities to persevere, to follow through Capacities of determination and grit

7. Coping Face and deal with disappointments, difficulties, even disasters Bounce back from troubles, from adversity, from the unexpected, from the truly awful

8. Flexibility Adaptability, capacity to shift gears It is not the strongest of the species that survives, nor the most intelligent. It is the one that is the most adaptive to change. - Charles Darwin

9. Resilience Deal with challenges and crises Bounce back from adversity Recover our balance and equilibrium Find refuges and maximize resources Cope skillfully, flexibly, adaptively Shift perspectives, open to possibilities, create options, find meaning and purpose

10. 6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

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

12. Compassion Respond to pain and suffering with open heart, interested mind, willingness to help Care, concern for problems and blocks that de- rail resilience Empathy, compassion for feelings and suffering of self, others Skillful behaviors in response to difficulties and differences

13. Clarity Focused attention on present moment experience Improves cognitive functioning Self-awareness, self-reflection Shifting perspectives Discerning options Choose wise actions

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

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

16. Courage Using signal anxiety as cue to: Try something new Take risks Persevere to achieve goals

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

18. Neuroscience of Resilience Neuroscience technology is 20 years old Meditation increases 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

19. Neuroplasticity 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

20. 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

21. 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

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

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

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

25. 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

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

27. 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

28. 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

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

30. Modes of Processing Focused Tasks and details Self-referential New conditioning and re-conditioning De-focused Default network Mental play space De-conditioning

31. De-Conditioning De-focusing Loosens grip Creates mental play space Plane of open possibilities Social self; process social interactions New insights, new behaviors PFC toggles; integrates

32. Mindfulness and Empathy 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

33. Integration Reflection See clearly Resonance Embrace wholeheartedly May I meet this moment fully; May I meet it as a friend.

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

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

36. 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

37. 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

38. 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

39. 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

40. Calm through the Body Hand on the Heart Body Scan Progressive Muscle Relaxation Movement Opposite

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

42. 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

43. Calm 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

44. Compassion Respond to pain and suffering with open heart, interested mind, willingness to help Care, concern for problems and stressors that de-rail resilience Empathy, compassion for feelings and suffering of self, others Skillful behaviors in response to difficulties and differences

45. Self-Compassion Threat-protection system Cortisol driven Pleasure-reward system Dopamine driven Caregiving-soothing-comfort system Oxytocin driven Paul Gilbert, The Compassionate Mind

46. Self-Compassion Powerful and immediate antidote to self- criticism, self-loathing Practice not to feel better but because we feel bad Putting own oxygen mask on first when other people are not around Come into loving connected presence Compassion leads to calm leads to clarity

47. Compassion for Others - Self Remember moment of compassion and care for another Evoke felt sense of compassion in your body When flow of compassion is steady… Place yourself in flow of compassion, care, concern

48. 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

49. 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

50. Clarity Focused attention on present moment experience Improves cognitive functioning Self-awareness, self-reflection Shifting perspectives Discerning options Choose wise actions

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

52. 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

53. Notice and Name Increasingly complex objects of awareness Sensations as sensations Thoughts as thoughts Patterns of thoughts as patterns of thoughts Cascades of emotions as cascades of emotions States of mind as states of mind Belief systems and identities as belief systems Awareness itself – vast sky storms pass through

54. Between a stimulus and a 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

55. 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.

56. 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.

57. 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.

58. 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

59. Anything is a Cue to Practice Notice any moment of contraction Use contraction as cue to: Step back, come to center Use practice to come to equilibrium Discern options, choose wisely

60. Modes of Processing Focused Tasks and details Self-referential New conditioning and re-conditioning De-focused Default network Mental play space De-conditioning

61. 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

62. Rest in Simply Being Awareness of Awareness Insights, epiphanies, revelations Wisdom teaches me I am nothing. Love teaches me I am everything. Between the two, my life flows. - Sri Nisargadatta

63. 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

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

65. 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

66. 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

67. Sleep Housekeeping Reset nervous system Consolidate learning Take mental breaks

68. 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

69. Nutrition Less Caffeine Less Sugar More Protein More Water

70. Nutrition Less Caffeine Less Sugar More Protein More Water

71. Movement - Exercise Oxygen – brain is 2% of body weight, uses 20% of body’s oxygen Endorphins – feel good hormones, brighten the mind Brain-Derived Neurotrophic Factor (BDNF) - grow new brain cells, will migrate to where needed

72. Laughter Increases oxygen and blood flow, reduces risk of heart disease and stroke Releases endorphins – body’s natural pain killer Reduces stress hormone cortisol, lowers blood pressure Triggers catecholamines, heightens alertness in brain Releases tension in body, balances nervous system

73. Laughter Promotes work productivity Reduces stress Promotes creativity and problem-solving Reduces mistakes, increases efficiency Promotes group cohesion Promotes learning (through play) Eases loss, grief, trauma

74. Laughter Yoga Let yourself laugh for 5-15 minutes, Gently at first, then relaxing into a deep belly laugh Happy baby pose (dead bug pose) Lying on the floor with your head in someone else’s lap; someone else’s head in your lap

75. Learn Something New Speak a foreign language Play a musical instrument Juggle Play chess Crossword puzzles when you don’t know the words

76. Hanging Out with Healthy Brains Brain is social organ; matures and learns best in interactions with other brains Social engagement regulates nervous system Resonant interactions prime the brain’s neuroplasticity; promotes learning and growth

77. Positive Emotions-Behaviors Brain hard-wired to notice and remember negative and intense more than positive and subtle; “negativity bias,” 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

78. Positive Emotions GratitudeAweGenerosity CompassionDelight Serenity Love Curiosity Kindness Joy Trust

79. 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

80. A hundred times every day, I remind myself that my inner and outer life depend on the labors of other people, and that I must exert myself in order to give in the same measure as I have received and am still receiving. - Albert Einstein

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

82. 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

83. 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

84. 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

85. Shifting Perspectives in Nature BELLY BOTANY Find a one square foot patch of earth. Observe for two minutes. (light and shadow, movement and stillness, beauty and decay, life and death) Shift your view to the larger landscape, all the way to the horizon. Reflect on shift in perspective.

86. People as Resources At times our own light goes out and is rekindled by the spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us. - Albert Schweitzer

87. True Other to 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 questions, and that is the answer. - Ken Benau, PhD

88. Ah, the comfort, The inexpressible comfort Of feeling safe with a person. Having neither to weigh out thoughts Nor words, But pouring them all right out, just as they are, Chaff and grain together; Certain that a faithful hand Will take them and sift them; Keeping what is worth keeping and, With the breath of kindness, Blow the rest away. - Dinah Craik

89. Seeing Ourselves as Others See Us Imagine sitting across from someone who loves you unconditionally Imagine switching places with them; see yourself as they see you; feel why they love you and delight in you; take in the good Imagine being yourself again; taking in the love and affection coming to you; savor and absorb.

90. The Guest House - Rumi This being human is a guest-house. Every morning a new arrival. A joy, a depression, a meanness, Some momentary awareness come As an unexpected visitor. Welcome and entertain them all! Even if they’re a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably.

91. 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 sent as a guide from beyond. - Rumi

92. 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

93. Love makes your soul crawl out of its hiding place. - Zora Neale Hurston Love guards the heart from the abyss. - Mozart

94. 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

95. 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

96. 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

97. 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

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

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

100. You can’t stop the waves, But you can learn to surf. -Jon Kabat-Zinn

101. 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

102. Competence Bodily felt sense of “Sure I can!” Based on previous competence No matter what, no matter how small Ownership

103. Learning Model Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence

104. 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

105. 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.

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

107. In every community, there is work to be done. In every nation, there are wounds to heal. In every heart, there is the power to do it. - Marianne Williamson

108. Courage Using signal anxiety as cue to: Try something new Take risks Persevere to achieve goals

109. Courage It’s as wrong to deny the possible As it is to deny the problem. - Dennis Seleeby

110. 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

111. 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

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