1. Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net Rewiring the Brain To Enhance Attachment Psychotherapy Networker Symposium Washington, D.C. March 18, 2016

2. Less-than-Secure Attachment Derails: Healthy relating to self and others Regulating the nervous system Emotional intelligence Self-awareness; self-acceptance Authenticity Resilience

3. Less-than-Secure Attachment Compromises maturation of brain Compromises development of pre-frontal cortex Integrative regulator of much of lower brain Center of executive functioning of higher brain Seat of inner secure base, seat of personal self CEO of resilience

4. Rewiring Capacities of Brain Regulate nervous system and emotions Attune, empathize with self and others Recover response flexibility and resilience Develop healthy authentic sense of self Become competent and courageous Contribute to larger world

5. Lenses of Workshop Therapy is an attachment relationship Recovers inner secure base of resilience Recovers capacities to love and be loved Neuroscience Rewires patterns of behavior Strengthens pre-frontal cortex Client becomes healthy, authentic, resilient, lovable and loving self

7. Secure Attachment Safety and trust Inner knowing and self-acceptance Theory of mind Capacities for coping Response flexibility

9. Secure Attachment Flexible focus on self and other Stay open to and engaged with experience Open to learning Thrive in resonant relationships Deal skillfully with challenging/toxic relationships

11. Insecure Avoidant Attachment Caregiver response Indifference or neglect Criticism, harsh judgment or shaming Developing child learns Autonomy v. affiliation Lone ranger Compulsively self-reliant

12. Insecure Avoidant in the Brain Contraction against engagement Avoidance of experience – people and emotions Focus on self and world rather than other Over-regulation of emotions Coping becomes defensive, rigid Neural cement, no learning

13. Insecure Anxious Attachment Caregiver response Unpredictable – sometimes loving, sometimes absent, sometimes pre-occupied Developing child learns Clinging to other, enmeshment Chameleon – who do I need to be to be loved by you? Compulsive caregiver

14. Insecure Anxious in the Brain Focus on other rather than self or world Under-regulation of emotions Coping becomes chaotic Neural swamp; learn doesn’t stick

15. Disorganized Attachment Caregiver response Dissociated, checked out from unresolved trauma Developing child learns Fright without solution Numbed out, paralyzed, dissociated

16. Disorganized Style in the Brain Lack of focus Lack of regulation Dis-integration of functioning

18. Therapeutic Modalities Internal Family SystemsEMDR CBTSomatic Experiencing Energy PsychologyAEDP EFTSensorimotor Psychotherapy Coherence TherapyDBT

20. 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

21. 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.

22. 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 Center for Investigating Healthy Minds University of Wisconsin-Madison

23. 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

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

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

26. 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 Without intervention, is what the brain does Conditioning is neutral, wires positive and negative

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, new habits, new ways of being

29. 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.”

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

31. 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.

32. Modes of Processing Focused Attention Tasks and details Deliberate, guided change New conditioning and re-conditioning De-focused Attention Default network Mental play space – random change De-conditioning

33. De-Conditioning Default network De-focusing, loosens grip of attention Creates mental play space, free association Can drop into worry, rumination Can drop into plane of open possibilities Brain makes new links, associations New insights, aha!s new behaviors

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

35. 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

36. Practices to Accelerate Brain Change Presence – primes receptivity of brain Intention/choice – activates plasticity Practice – creates new pathways, new more resilient habits of coping Perseverance – “little and often” installs change

37. Intelligences Somatic:Body-based equilibrium Emotional: managing one’s own emotions and empathizing with others’; compassion Relational: connect, heal heartache, access resources, navigate peopled world Reflective: conscious awareness, mindfulness

38. Somatic Intelligence Body-based tools to regulate nervous system Regulate stress (over-activation of SNS) Regulate collapse (over-activation of PNS) Oxytocin – direct, immediate antidote to cortisol Hand on heart, warm safe touch, hugs

39. Exploring therapeutic relationship Client’s experience of themselves with you Client’s perception of your experience of them Client receiving your experience of them Client revising their experience of themselves based on your perception of them

40. 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

41. Rewiring Shame with Movement Body inhabits posture of shame (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

42. Negativity Bias – Left Shift 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

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

44. Mindful Self-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)

45. 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 Common Humanity I am not alone; I am not the only one Activates caregiving system Shift from reactivity and contraction to openness, engagement

46. Practices of Mindful Self-Compassion Affectionate Breathing Soles of the Feet Self-Compassion Break Caregiving: One for Me, One for You Caregiving with Equanimity

47. 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

48. 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

49. 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

50. Caregiving 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

51. 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.

52. To see and be seen: that is the question, and that is the answer. - Ken Benau, PhD

54. 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

55. Love Physical proximity Eye contact Mutual care Neurochemical synchrony = Love Barbara Fredrickson, Love 2.0

56. 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.

57. 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

58. 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”

59. 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

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

61. 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

62. 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

63. 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

64. 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

65. 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

66. Mindfulness and Psychotherapy Even-hovering attention Unconditional positive regard Observing ego “What are you noticing now?” Catch the moment; make a choice

67. Noticing and Naming Comfort in Relationship Stand facing each other; eyes open; eyes closed Stand back to back Stand facing but taking turns looking down, looking away

68. Noticing Patterns of Reactions Imagine walking down the street Notice someone you know walking toward you Wave “hello!” There’s no response. Notice your response to the lack of response The person notices you and waves “hello!” Notice your response to the response Notice any differences in your responses

69. 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.

70. 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.

71. 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.

72. 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

73. 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. - Dave Richo

74. Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net Rewiring the Brain To Enhance Attachment Psychotherapy Networker Symposium Washington, D.C. March 18, 2016