Transcript Slide 1
Brain Care:
The Neuroscience of Self Care
Esalen Institute
May 8-10, 2015
Linda Graham, MFT
[email protected]
www.lindagraham-mft.net
415-924-7765
Linda Graham, MFT
Marriage and Family Therapist – 25 years
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
[email protected]
www.lindagraham-mft.net
Brain Care is Self Care
Nourish and replenish brain; nourish and
replenish self
Choose new experiences; harness
neuroplasticity
Mechanisms of brain change: conditioning,
new conditioning, re-conditioning, deconditioning
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
6 C’s of Coping
Calm
Compassion
Clarity
Connections to Resources
Competence
Courage
Kindness is more important than wisdom,
And the recognition of that is the beginning of
wisdom.
- Theodore Rubin
Share-listen-reflect stories of kindness received
Hand on the Heart
Touch
Deep breathing
Positive Emotions
Brakes on survival responses
Restore coherent heart rate variability
Oxytocin – safety and trust
Relationships as resources
How to Replenish Human Brain
Exercise-Movement
Sleep – Mental Breaks
Nutrition
Laughter-Play
Learn Something New
Hang Out with Healthy Brains
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
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
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
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
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
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
The field of neuroscience is so new,
we must be comfortable not only
venturing into the unknown
but into error.
- Richard Mendius, M.D.
Evolutionary legacy
Genetic templates
Family of origin conditioning
Norms-expectations of culture-society
Who we are and how we cope….
…is not our fault.
Given neuroplasticity
And choices of self-directed neuroplasticity
Who we are and how we cope…
…is our responsibility
Paul Gilbert, PhD, The Compassionate Mind
Pre-Frontal Cortex
Executive center of higher brain
Evolved most recently – makes us human
Development kindled in relationships
Matures the latest – 25 years of age
Evolutionary masterpiece
CEO of resilience
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
Planning, decision making
Mechanisms of Brain Change
Conditioning
New Conditioning
Re-Conditioning
De-Conditioning
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
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
How you respond to the issue…is the issue.
- Frankie Perez
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.”
The curious paradox is that when I accept
myself just as I am, then I can change.
- Carl Rogers
Re-conditioning
“Light up” neural networks
Juxtapose old negative with new positive
De-consolidation - re-consolidation
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
Tasks and details
New conditioning and re-conditioning
De-focused
Default network
Mental play space
De-conditioning
De-Conditioning
Default network
De-focusing; loosens grip
Creates mental play space
Can open to worry, rumination
Can open to plane of open possibilities
Brain makes new links, associations
New insights, new behaviors
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
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 – create new pathways, new more
resilient habits of coping
Perseverance – creates and installs change
6 C’s of Coping
Calm
Compassion
Clarity
Connections to Resources
Competence
Courage
Calm
Manage disruptive emotions
Tolerate distress
Down-regulate stress to return to baseline
equilibrium
Compassion
Being touched, moved by experience of pain and
suffering
Flow of kindness, tenderness, care and concern
toward experiencer of pain and suffering
Wise action to alleviate pain and suffering
One cannot live with sighted eyes and feeling heart
and not know the misery which affects the world.
- Lorraine Hansberry
Compassion is a verb. – Thich Nhat Hanh
Clarity
Pause, become present
Notice and name
Step back, dis-entangle, reflect
Shift perspectives; shift states
Discern options
Choose wisely – let go of unwholesome,
cultivate wholesome
Connections
Increasing the social connections in our lives is
probably the single easiest way to enhance our
well-being.
- Matthew Lieberman, UCLA
author of Wired to Connect
Competence
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
Courage
Using signal anxiety as cue to:
Try something new
Take risks
Move resilience beyond personal self
Keep Calm and Carry On
Serenity is not freedom from the storm
but peace amidst the storm.
- author unknown
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
Deep breathing
Positive Emotions
Brakes on survival responses
Restore coherent heart rate variability
Oxytocin – safety and trust
Relationships as resources
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
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
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
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
Compassion Practice
Mindfulness
Awareness of what’s happening
(and our reaction to what’s happening)
Self-Compassion
Acceptance of what’s happening
(and our reaction to what’s happening)
Compassion – Common Humanity
Wise effort in response to what’s happening
(and our reactions to what’s happening)
Self-Compassion
Threat-protection system
Cortisol driven
Pleasure-reward system
Dopamine driven
Caregiving-soothing-comfort system
Oxytocin driven
Paul Gilbert, The Compassionate Mind
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
Activates caregiving system
Shift from reactivity and contraction to openness,
engagement
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
Loving Kindness with
Self-Compassion
Sit comfortably, focus on gentle breathing, in and out
Feel breath in entire body; let your body breathe you
Breathe into areas of physical stress, discomfort
Notice difficult emotions; incline awareness toward
contraction or discomfort
Self-compassion phrases: “May I be….”
Your own phrases of kindness, tenderness, care
Rest in stillness and peace in body
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.
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
Positive Emotions
Gratitude
Awe
Generosity
Compassion
Delight
Serenity
Love
Curiosity
Kindness
Joy
Trust
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
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
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: felt sense in the body
Absorb: savor 10-20-30 seconds
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 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
Mindfulness Comes to West
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
Catch the moment; make a choice
Shift perspectives; shift states
Discern options
Choose wisely – let go of unwholesome,
cultivate wholesome
Notice and Name
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…
Mental contents, patterns of neural firing
All mental patterns are optional
Notice Patterns of Reaction
Imagine walking down the sidewalk, noticing
someone you know walking on the other side
of the street toward you
Imagine you wave and call out “Hello!”
There’s no response; notice your reaction.
Now imagine the person notices you, waves
and calls out “Hello!” Notice your reaction
Reflect on the differences in your reactions.
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
Mindfulness
Catch the moment; make a choice
- Janet Friedman
Every moment has a choice;
Every choice has an impact.
- Julia Butterfly Hill
Breathing into Infinity
Focus awareness on breathing, and on
awareness of breathing, and on awareness
Extend awareness to people near you; people
you know; people in neighborhood, region,
country, all over the planet
Extend awareness to all creatures; to earth
itself
Extend awareness beyond planet; always
remain aware of awareness.
Brahma Viharas
Loving Kindness
Compassion
Sympathetic Joy
Equanimity
Send and receive wishes to and from your
partner
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.
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
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 moment we cease to hold one another, the sea
engulfs us and the light goes out.
- James Baldwin
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
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
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
Neuroscience of Empathy
Emotional communication is 93% non-verbal
Social engagement system
Dyadic regulation
Vagal brake
Fusiform gyrus regulates amygdala
Restores equilibrium
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
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.
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?
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.
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
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”
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
Love makes your soul crawl out of its hiding
place.
- Zora Neale Hurston
Love guards the heart from the abyss.
- Mozart
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
Relational Intelligence
Reaching out and asking for help
Setting limits and boundaries
Negotiating change
Resolving conflicts
Repairing ruptures
Forgiveness
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.
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.
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.
Forgiveness is not an occasional act;
It is a permanent attitude.
-Martin Luther King, Jr.
Competence
Bodily felt sense of “Sure I can!”
Based on previous competence
No matter what, no matter how small
Ownership
Competence
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
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.
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
Courage
It’s as wrong to deny the possible
As it is to deny the problem.
- Dennis Seleeby
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
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
I am no longer afraid of storms,
For I am learning how to sail my ship.
- Louisa May Alcott
How to Replenish Human Brain
Exercise-Movement
Sleep – Mental Breaks
Nutrition
Laughter-Play
Learn Something New
Hang Out with Healthy Brains
Exercise - Movement
Macro
cardio – BDNF
Yoga, qi gong – move the energy
Micro
3-minute better than nothing workout
Move your body once every hour
Sense and savor walk
Sleep - Rest
Macro – 8 hours every night
Housekeeping
Reset nervous system
Consolidate learning
Sleep hygiene
Micro
Take mental breaks; switch the channel
Take a nap
Mini-meditate (10 breaths)
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
Macro
Eat healthy!
More protein, more water, less sugar, less carbs,
less calories, less caffeine/alcohol
Micro
Savor (eat a raisin meditation)
Eat one meal a day without doing anything else
Laughter-Play
Macro
Have a good time at family/friends
dinner/celebration
Schedule a play date
Schedule a silly date
Micro
Watch a 4-minute Happify Daily video
Read two minutes of jokes
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
Hang Out with Healthy Brains
Macro
Friendships, extra-curricular activities and clubs,
athletics, choir
Practice gratitude at family dinners
Micro
Read 10 pages of a good book, magazine article, blog
post
Send the link of the above to a friend
Send a text or email of gratitude, acknowledgement,
appreciation to friend, co-worker
Brain Care is Self Care
Choose one practice of brain care
Practice every day for 30 days
Reflect on difference in functioning, in
resilience and well-being, in sense of self