Full Course Description
- Determine the neurophysiology of the stress response, including the roles of the amygdala, hypothalamus, sympathetic and parasympathetic nervous systems, and the effects of cortisol and adrenaline.
- Discriminate among acute stress, major life events and chronic stressors, and the longer-term effects of chronic stress on mind and body.
- Implement grounding strategies to help clients who experience “freeze” states or dissociative symptoms.
- Communicate the concept of mindfulness, how it affects the brain, and how to use mindfulness-based interventions in therapy.
- Critique the concept of self-compassion and research on its benefits.
- Design practical exercises to increase self-compassion in clients facing stress.
- Analyze the importance of perceived control to the impact of stressors and learn how to help clients differentiate controllable and uncontrollable aspects of stressors.
- Explore how stress and anxiety narrow cognitive focus and create thinking traps and learn techniques to help clients be more cognitively flexible in the face of stress.
- Evaluate the research suggesting that positive emotions can undo the physiological effects of negative emotions.
- Investigate how rumination exacerbates the effects of stress and how to help clients curtail ruminative cycles and de-fuse from negative thinking.
- Appraise how a growth mindset differs from a fixed mindset and how to help clients adopt a growth mindset and a gritty attitude towards their stressors.
- Assess the application of a brain-based, neuroscience approach to treating clinical disorders like GAD and PTSD.
Using Neuroscience in Treatment of Stress and Trauma
- Science gives authority, evidence, de-stigmatizes mental health problems
- Increased motivation and hope for change
- Oversimplification, unrealistic expectations, changing state of science, see self as damaged or different
The Promise of Neuroplasticity
- Describe neuroplasticity in everyday language
- Therapy is about creating a new, more resilient brain
- We are changing beings - don’t have to be stuck in rigid views of self
- Teach brain to be less reactive to stress and triggers
- “Rewiring” as a metaphor for change
- Changing “raw,” unprocessed memories to organized narratives
The Brain’s Stress Response
- Historical view - Hans Selye
- The brain’s stress response “fight, flight, freeze”
- The triune brain - reptilian, mammalian, human
- The amygdala and the prefrontal cortex
- How the amygdala “hijacks” the brain into emergency mode
How the Stress Response is Spread Throughout the Body
- Neurotransmitters - Epinephrine, norepinephrine and cortisol
- The HPA axis and role of cortisol
- The sympathetic and parasympathetic nervous systems
- The dorsovagal “freeze” response to unavoidable threat
The Upside and Downside of Stress
- Increased motivation and engagement - “flow”state
- Can create mental toughness and resilience to future stressors
- Inflammatory response to chronic stress
- Stress and health risk behaviors (excess alcohol use, smoking, overeating etc)
- Stress and cellular aging (telomeres)
Traumas - Effects on the Brain
- Cortisol attacks the hippocampus - center of narrative memory
- Amygdala response increases in strength
- Impaired anterior cingulate cortex (ACC) and prefrontal cortical function
- Cortisol halts production of BDNF - fewer new brain cells formed
- Link to depression, anxiety disorders, PTSD
- Cognitive rigidity and inability to take in new information
- Changes in sense of self and dissociation
Long-Term Impact of Adverse Childhood Experiences (ACEs)
- The ACE Study (Kaiser and the CDC)
- Addictive and unhealthy ways of managing anxiety & negative emotions
- Disease, mental health issues, behavioral problems, PTSD
Explaining Neuroscience Concepts to Clients
- Use drawings and images
- Individualize to the type of difficulty (e.g., disengaged vs reactive - different brain areas)
- Redirect vs eliminate
- Help client label & recognize when happening (e.g., freeze, flooding, negative thinking, rigidity, impulsivity)
- Find coping strategies for each type of brain difficulty
Stress-Proofing the Brain - Overview
- Calming the amygdala - Grounding, mindfulness, self-compassion, perceiving control
- Moving forward with the prefrontal cortex - Cognitive reappraisal, priming positive mindsets and, growth focus, health psychology tools
Grounding Strategies for Clients with Trauma or Attachment Injuries
- Yoga, relaxation, breathing, present-moment focus, soothing with the senses, pets, drawing, gardening, walking
- Mental imagery - safe place, boundaries, energetic, times they felt strong/competent
- Left-brain strategies - task focus and engagement
- Qualities of mindfulness states - open, nonjudgmental, fluid, deliberate,
- Observing and accepting inner experience (thoughts, feelings, sensations)
- Using the senses to self-regulate
- De-fusing from negative thoughts and self-images
- How mindfulness changes the brain
- Mindfulness practices - breathing, watching thoughts, urge surfing, open awareness
- Application to anxiety, depression, addictions, PTSD
- Self-kindness, common humanity, focus on unmet needs
- Application to depression, anxiety, stress-management, trauma, insecure attachment
- Link to Schema Therapy - healthy adult mode
- Practices - Metta meditation, soften, soothe and allow, dialogues with inner critic
- How stress and anxiety narrow attention, create cognitive rigidity
- Depression and negative thinking
- PTSD and internalized negative appraisals (helpless, unworthy, unsafe etc.)
- Worry and rumination cycles - link to prefrontal cortex and default mode network
- Why thought suppression doesn’t work
- De-catastrophizing and probability estimation
- Exposure and tolerating negative thoughts
- Using metaphors (monsters on the boat, bouncy ball underwater)
Creating Positive States of Mind to Counter Stress
- How our brains are wired to the negative
- Positive emotions can promote physiological recovery from anxiety and fear
- Reappraising anxiety as excitement
- Gratitude diaries
- Commitment, control, and challenge; growth mindset
Living Healthy in the Face of Stress
- Sleep disturbance - behavioral strategies
- Healthy coping strategies - exercise, meditation, yoga
- Dealing with emotional eating