1. San Francisco CAMFT May 4, 2014 San Francisco, CA.

2. Linda Graham, MFT www.lindagraham-mft.net linda@lindagraham-mft.net Bouncing Back: Rewiring Your Brain For Maximum Resilience and Well-Being

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

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

5. Premise of Workshop Different neural activities underlie Different levels of client functioning, thus Different mechanisms of therapeutic change Harness neuroplasticity of brain Teach self-directed neuroplasticity to clients Increase effectiveness of any modality

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

7. Neuroscience of Resilience Neuroscience technology is 20 years old Meditation shifts mood and perspective; impacts immune system and gene expression Oxytocin can calm a panic attack in less than a minute Kindness and comfort, early on, protects against later stress, trauma, psychopathology

8. 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

9. 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

10. 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

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

12. Mindfulness and Empathy Awareness of what’s happening (and our reactions to what’s happening) “What are you noticing now?” Acceptance of what’s happening (and our reactions to what’s happening) “Oh, sweetheart! This is painful; this is hard. And it makes complete sense that you would feel the way you do. Two most powerful agents of brain change known to science

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

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

15. Conditioning – Skills and Patterns The brain learns from experience Encodes learning, behaviors, skills in neural circuitry Patterns of response become automatic habits Develops or de-rails pre-frontal cortex CEO of resilience Inner secure base, personal sense of self Therapeutic relationship = re-parenting

16. New Conditioning – New Resources New skills, behaviors, capacities Develop resilient coping Antidote negativity bias of brain Strengthen resources; take in the good

17. Re-conditioning – Rewiring Patterns Stabilize functioning Reduce stress, defensiveness Heal trauma Window of tolerance – equilibrium Memory deconsolidation – reconsolidation

18. De-conditioning – Quantum Learning Default network Mental play space Open spacious awareness Insights, aha!s, breakthroughs

19. 6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

20. Conditioning: How the Brain Learns in the First Place 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

21. 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

22. 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

23. 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

24. 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

25. Pre-Frontal Cortex - Functions 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

26. Mindfulness Comes to West Mindfulness: Focused attention on present moment experience without judgment or resistance. - Jon Kabat-Zinn Attention and allowing Awareness and acceptance

27. Mindfulness Pause, become present Notice and name See patterns as patterns 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

28. 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

29. 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.

30. 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.

31. 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.

32. 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

33. Clarity 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 Every moment brings a choice, and every choice has an impact. Julia Butterfly Hill

34. New Conditioning Experience creates brain change New experiences: new learning, new skills, new behaviors New memory, new circuitry

35. Negativity Bias – Positive Emotions Brain is 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

36. Positive Emotions-Behaviors GratitudeAweGenerosity CompassionDelight SerenityLoveCuriosity KindnessJoyTrust

37. 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

38. Gratitude 2-minute free-write Gratitude journal Gratitude buddy Gratitude in the middle of the night

39. 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

40. 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

41. 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

42. Re-conditioning Managing survival responses Rewiring shame Rewiring trauma

43. 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

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

45. Hand on the Heart Touch Deep breathing Positive Emotions Brakes on survival responses Oxytocin – safety and trust Relationships as resources

46. 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

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

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

49. 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

50. Calm and Strength through Movement Power posing Body posture of difficult emotion Body moves into opposite posture Return to first posture Return to second posture Find a position in the middle

51. 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

52. Neuroscience of Empathy Emotional communication is 93% non-verbal Social engagement system Dyadic regulation Fusiform gyrus regulates amygdala Vagal brake Restores equilibrium

53. 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

54. Wiser Self Imagine yourself five years from now: wise, compassionate, good, strong, alive and vibrant Ask this Wiser Self: how did you become like this? What did you have to overcome or let go of to become like this? What one word of advice do you have for me? Inhabit this Wiser Self briefly; what does it feel like to become your Wiser Self?

55. The curious paradox is that when I accept myself just as I am, then I can change. - Carl Rogers

56. Compassion Sensitivity Attention to feelings and suffering, self and others Sympathy Tuning in, feeling with, being moved Distress tolerance Being with pain without denial or overwhelm Empathy Understanding without judgment, resistance, submission Caring Warmth, kindness, gentleness in any response

57. 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 Share experience with resonant other

58. 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.

59. 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

60. 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

61. 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

62. 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.

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

64. 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

65. 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

66. See Yourself as Others See You 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.

67. Welcome Them All Wiser Self welcomes to the “party” characters that embody positive and negative parts of the self with curiosity and acceptance of the message or gift of each part and honors each part of the “inner committee”

68. Shame is De-Railer of 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.

69. Cure for Shame is Love and Acceptance Love makes your soul crawl out of its hiding place. - Zora Neale Hurston Love guards the heart from the abyss. – Mozart

70. 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

71. 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 Casues the falling apart and the rewiring

72. 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

73. 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

74. Rewiring Trauma Mindfulness and compassion as container Dropping through layers of story, feelings to body sensations where trauma is stored Chunking down the memory to be processed Holding the memory in larger resourcing Pendulating between positive and negative, refreshing positive, until negative dissolves or loses charge

75. Modes of Processing Focused Tasks and details Self-referential New conditioning and de-conditioning De-focused Default network Fertile neural background noise Plane of open possibilities De-conditioning

76. Defocused mode Dreams Daydreams, reveries Stream of consciousness Imagination Guided visualization

77. 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

78. I am larger than I thought. I did not know I held so much goodness. - Walt Whitman Love teaches me I am everything. Wisdom teaches me I am nothing. Between the two, my life flows. - Sri Nisargadatta

79. 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

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

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

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

83. How long should you try? Until. - Jim Rohn The difference between try and triumph is a little “umph.” – author unknown The greatest oak was once a little nut that held its ground. – Author unknown

84. Linda Graham, MFT www.lindagraham-mft.net linda@lindagraham-mft.net