1. Bouncing Back: Rewiring the Brain for Resilience and Well-Being Stanislaus County Behavioral Health and Recovery Services July 11, 2014

2. Bouncing Back Rewiring the Brain for 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. Boundin’ video

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

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

7. Resilience Hardiness Coping Flexibility

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

9. 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

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

11. 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

12. 6 C’s of Coping Calm Compassion Clarity Connections to Resources Competence Courage

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

14. 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

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

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

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

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

19. Evolution of Human Brain Reptilian – brainstem Mammalian – limbic Human - cortex

20. Avoid Brainstem – assess safety-danger Limbic – automatic survival responses Cortex – strategies for withdrawal, limits and boundaries, defenses

21. Approach Brainstem – seek pleasure/reward Limbic – seek protection and comfort Cortex – seek empathy, understanding, validation; conscious reflection, choices

22. Attach Brainstem – fear-attachment-exploration motivational system Limbic – emotional valence of experience Cortex – regulate emotions; “rules” of relationship, social-emotional intelligence Kindles maturation of pre-frontal cortex

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

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

31. 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.

32. 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

33. 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

34. 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

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

36. 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

37. 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

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

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

40. De-Conditioning Default network De-focusing, loosens grip Creates mental play space Plane of open possibilities Brain makes new links, associations New insights, new behaviors

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

42. Kindness is more important than wisdom, And the recognition of that is the beginning of wisdom. - Theodore Rubin

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

44. 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

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

46. Conditioning Neurons that fire together wire together. - Donald Hebb

47. Conditioning Brainstem: No! Yes. Limbic: 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 Cortex: Attachment patterns of response

48. Intelligences Somatic - body-based, rewire trauma Emotional - from survival responses to thriving Relational - heal heartache, access havens and resources, navigate peopled world Reflective – conscious awareness; catch the moment, make a choice

49. New Conditioning Brain more resilient Brain more receptive Strengthen pre-frontal cortex We are more resilient

50. Cues to Practice - ANTS to PATS Identify habitual negative pattern of response Identify new, positive response to counter/replace Identify cue word or phrase to name negative and positive Criticism - Compassion Use cue to break automaticity and change the channel Repeat the practice as many times as necessary

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

52. 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

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

54. Wiser Self Imagine being in your safe place Imagine meeting your Wiser Self who embodies all of your best qualities and strengths Ask your Wiser Self How did you come to be wise, happy, content? What did you have to overcome? Listen to words of advice for your journey Receive object to remember Wiser Self by

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

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

58. 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

59. 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 cherizhed Oxytocin – direct and immediate antidote to stress hormone cortisol

60. 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

61. 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

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

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

64. 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

65. 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

66. 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

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

68. 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

69. 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

70. 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

71. 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

72. 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

73. Courage Yes, risk-taking is inherently failure-prone. Otherwise, it would be called sure thing- taking - Tim McMahon

74. 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

75. 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

76. Practices as Resources Yoga, meditation, tai chi, chi gong Sleep Nutrition Movement-Exercise Laughter Learn Something New Hanging Out with Healthy Brains

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

78. 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

79. Nutrition Less Caffeine Less Sugar More Protein More Water

80. 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

81. 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

82. 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

83. 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

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

85. 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

86. 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

87. The Peace of Wild Things When despair for the world grows in me and I wake in the night at the least sound in fear of what my life and my children’s lives may be, I go and lie down where the wood drake rests in his beauty on the water, and the great heron feeds. I come into the peace of wild things who do not tax their lives with forethought of grief. I come into the presence of still water. And I feel above me the day-blind stars waiting with their light. For a time I rest in the grace of the world, and am free. - Wendell Berry

88. One summer night, out on a flat headland, all but surrounded by the waters of the bay, the horizons were remote and distant rims on the edge of space. Millions of stars blazed in darkness, and on the far shore a few lights burned in cottages. Otherwise there was no reminder of human life. My companion and I were alone with the stars: the misty river of the Milky Way flowing across the sky, the patterns of the constellations standing out bright and clear, a blazing planet low on the horizon. It occurred to me that if this were a sight that could be seen only once in a century, this little headland would be thronged with spectators. But it can be seen many scores of night in any year, and so the lights burned in the cottages and the inhabitants probably gave not a thought to the beauty overhead; and because they could see it almost any night, perhaps they never will. - Rachel Carson

89. Shifting Perspectives in Nature BELLY BOTANY Select a one square foot patch of earth. Observe patch from two feet away/above 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.

90. Emotions Signals to take action Adaptive action tendencies Anger – Sadness – Fear –

91. 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.

92. 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

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

94. 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

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

96. 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

97. Left shift Positive emotions cause more neural firing in left hemisphere of brain Left hemisphere more oriented to approach stance toward experience, openness to learning Openness to learning, flexibility, options = resilience

98. 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

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

100. 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

101. 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

102. 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

103. 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

104. 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

105. 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

106. 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 questions, and that is the answer. - Ken Benau, PhD

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

108. 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

109. 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

110. 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

111. 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

112. 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 questions, and that is the answer. - Ken Benau, PhD

113. 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

114. Empathy I hear you say…. I see that you…. I sense that you… I’m touched that you… Rather than “I think that you….”

115. Resonance Circuit Resonance – vibe, emotional contagion Attunement – felt sense, explicit, non-verbal Empathy – verbal, cognitive, coherent narrative Compassion – concern, caring, help Acceptance – pre-requisite for resilience and lasting change

116. Theory of Mind I know that you can be thinking and feeling something completely different from what I’m thinking and feeling, and that’s OK.

117. 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.

118. 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”

119. Relational Intelligence Receiving/reaching out for help Setting limits and boundaries Negotiating change Resolving conflicts Repairing ruptures Forgiveness

120. Receiving/Reaching Out for Help Self-compassion for human vulnerability Identify behaviors, resources that would be helpful Ask for help (don’t rely on mind-reading) Receive help; take in the good If help not available, seek other resources

121. Setting Limits and Boundaries Permission to assert request without aggression or collapse Cultivate mindful empathy for self and other State values, needs, desires State the limit and consequences (When practicing, partner accepts limit)

122. Negotiating Change Code to initiate dialogue; agreement to follow protocol Speaker states topic, then shares experience, progressing from perceptions of behaviors to emotional needs, fears, desires Listener listens; no debate, defense, rebuttal Summary of concern

123. Negotiating Change, part 2 Speaker identifies three behaviors he/she is willing to do to address emotional needs Speaker identifies three behaviors partner can do to address emotional needs Each chooses one; must be specific, positive, within defined time frame Each acknowledges when other does the new behavior

124. Resolving Conflicts Acknowledge conflict Identify possible misunderstandings, mis- perceptions Take responsibility for your part in conflict Convey your responsibility to other; ask them to reflect on their responsibility for their part Brainstorm possible solutions; come to agreement

125. Repairing Ruptures Focus on repairing the relationship, not on right v. wrong Value of relationship, motivation to repair Mindful empathy for each other Share experiences, not opinions Convey understanding of experience, care for person Re-engage from more resonant space

126. Forgiveness - I For the many ways that I have hurt and harmed myself, that I have betrayed or abandoned myself, out of fear, pain, and confusion, through action or inaction, in thought, word or deed, knowingly or unknowingly… I extend a full and heartfelt forgiveness. I forgive myself. I forgive myself.

127. Forgiveness - II For the ways that I have hurt and harmed you, have betrayed or abandoned you, caused you suffering, knowingly or unknowingly, out of my pain, fear, anger, and confusion… I ask for your forgiveness, I ask for your forgiveness.

128. Forgiveness - III For the many ways that others have hurt, wounded, or harmed me, out of fear, pain, confusion, and anger… I have carried this pain in my heart long enough. To the extent that I am ready, I offer you forgiveness. To those who have caused me harm, I offer my forgiveness, I forgive you.

129. Forgiveness is not an occasional act; It is a permanent attitude. -Martin Luther King, Jr.

130. 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

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

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

133. 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 Cover of Time magazine, February 3, 2014

134. 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

135. 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

136. 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 as identities and Mental contents, patterns of neural firing Awareness itself – vast sky that storms pass through

137. 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

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

139. 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.

140. 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.

141. 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.

142. 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.

143. 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

144. Modes of Processing Focused Tasks and details Self-referential Defocused Default network Plane of open possibilities

145. 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

146. 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

147. 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

148. Consciousness True Nature Wiser Self Adult Self Inner Child

149. Brahma Viharas Loving Kindness Compassion Sympathetic Joy Equanimity

150. Presence To be present is far from trivial. It may be the hardest work in the world. And forget about the “may be.” It is the hardest work in the world – at least to sustain presence. And the most important. - Jon Kabat-Zinn

151. Intention And the day came when the risk it took To stay tight inside the bud Was more painful than the risk it took to blossom. - Anais Nin

152. Perseverance 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

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

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

155. 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

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

157. Learning Model Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence

158. How to Create a New Habit Identify new behavior you want to cultivate Identify reward for new behavior; how will you sense that reward in your body? Identify first five seconds of new behavior Identify cue to begin the first five seconds of behavior

159. Cues to Practice - ANTS to PATS Identify habitual negative pattern of response Identify new, positive response to counter/replace Identify cue word or phrase to name negative and positive Criticism - Compassion Use cue to break automaticity and change the channel Repeat the practice as many times as necessary

160. 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

161. 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.

162. Deep Listening The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention….A loving silence often has far more power to heal and to connect than the most well-intentioned words. - Rachel Naomi Remen, M.D.

163. Deep Listening Listener asks speaker the question. Speaker answers honestly. The speaker answers the repeating question for several rounds, deepening his/her understanding of his/her experience. Listener and speaker switch roles. Take a few moments to share reflections on the experience.

164. Questions for Deep Listening What brings you joy in your life? What has brought you sorrow? What worries you now? When have you found courage in dark times? What are you grateful for? What are you proud of?

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

166. A ship is safe in harbor, but that’s not what ships are for. - Grace Hopper

167. 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

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

169. 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

170. Mastering the art of resilience does much more than restore you to who you once thought you were. Rather, you emerge from the experience transformed into a truer expression of who you were really meant to be. - Carol Orsborn

171. Bouncing Back Rewiring the Brain for Resilience and Well-Being Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net 415-924-7765