1. Linda Graham, MFT lindagraham2@earthlink.net www.lindagraham-mft.net The Neuroscience of Mindfulness and Compassion In Psychotherapy California Institute of Integral Studies November 21, 2013

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

3. Neuroscience Self-Directed Neuroplasticity Response Flexibility Consciousness Psychotherapy Compassion Reflective-Relational

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

5. 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

6. Neuroplasticity Growing new neurons Strengthening synaptic connections Myelinating pathway – faster connections Rebuilding brain structure Re-organzing functions of structures ….lifelong

7. Evolutionary legacy Genetic loading Family of origin conditioning Norms-expectations of culture-society Who we are and how we cope… …is not our fault.

8. Given neuroplasticity And choices of self-directed neuroplasticity Who we are and how we cope… …is our responsibility.

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. 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

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

12. Suffering Expression of genes Encoding of patterns of response Maturation of brain structure

13. Attachment Styles Secure – safety and trust, stable and flexible, open to learning; flexible focus Insecure avoidant – mistrust of emotions and relationships, over-focus on self-world; rigid, neural cement Insecure-anxious – mistrust of self, over-focus on relationships; chaotic, neural swamp Disorganized – checked out, lack of focus

14. Attachment - Hindrances Secure - True Nature, Wiser Self Insecure avoidant – aversion/hatred Insecure anxious – greed, grasping, clinging Disorganized – delusion, confusion

15. 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

16. 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 experience Insight and self-knowing Response flexibility

17. Effective Agents of Brain Change Mindfulness – Attention Circuit Compassion – Resonance Circuit Learn How These Work in the Brain Strengthen pre-frontal cortex Increase response flexibility Alleviate suffering

18. Mechanisms of Brain Change New Conditioning – focused attention De-Conditioning – de-focused attention Re-Conditioning – applied attention

19. Five Practices to Accelerate Brain Change Presence Intention Perseverance Refuges Resources

20. Six Cs of Coping Calm Compassion Clarity Connections to resources Competence Courage

21. Compassion leads to Calm leads to Clarity

22. Resonance Circuit Resonance – vibe, emotional contagion Attunement – felt sense, explicit, non-verbal Empathy – verbral, cognitive, coherent narrative Compassion – concern, caring, help Acceptance – prerequisite for resilience

23. Compassion Respond to pain of suffering with an open heart, an interested mind, and a natural willingness to help. Open to experience, activate care-giving, prime ourselves to act. Left shift in bran – more neural activity in left hemisphere – approach stance toward experience Overcome negativity bias – become more optimistic, more flexible, better resources, better able to find solutions.

24. Self-Compassion Notice this is a moment of suffering Ouch! This hurts. What would be comforting here? What would be helpful? Open to larger perspective Im not the only one; Im not alone.

25. Serenity is not freedom from the storm But peace amidst the storm. - Author unknown

26. 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

27. Self- Compassion Break How am I doing? Is there any suffering here? How can I be mindful and compassionate in this moment? May I be safe from inner and outer harm May I be free of suffering, all causes of suffering, and from causing any suffering

28. Touch Hand on heart, hand on cheek Head rubs, foot rubs Massage back of nect Hugs – 20-seconds, full-bodied

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

30. Soothing, Comforting, Caring Dyadic Regulation Breathing – equanimity for two Progressive Muscle Relaxation Friendly Body Scan Movement Opposite

31. Compassion leads to Calm…leads to Clarity

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

33. Mindfulness Pause, become present Notice and name Step back, dis-entangle, reflect Monitor and modify Shift perspectives Discern options Choose wisely

34. 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 ones attitude in any given set of circumstances. - Viktor Frankl

35. Mindfulness Pause, become present Notice and name Step back, dis-entangle, reflect Monitor and modify Shift perspectives Discern options Choose wisely

36. Notice and Name Thoughts as thoughts Patterns of thoughts as patterns of thoughts States of mind as states of mind Identify belief systems and identities as Mental contents, patterns of neural firing

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

38. Nesting Dolls Consciousness – Being True Nature Wiser Self Adult Self Inner child

39. Resilience and Well-Being Somatic Intelligence Emotional Intelligence Relational Intelligence Social Intelligence Compassionate communication Setting limits and boundaries Negotiating change Repairing a rupture Forgiveness

40. Connections to Resources People Love guards the heart from the abyss - Mozart Places …I rest in the grace of the world...Wendell 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

41. Positivity Portfolio Ask 10 friends to send cards 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. Practices as Resources Paradigms – yoga, meditation, chi gong, prayer Movement – exercise Nutrition Sleep Laughter Learning Hanging Out with Healthy Brains

43. Positive Emotions Help us feel and function better Put the brakes on negativity Antidote survival responses Foster the left shift; open to experience Broaden possibilities in the moment Build resources long term Build resilience

44. Positive Emotions Create: Better health and longevity Deeper social bonds Better coping with stress and trauma Creativity and productivity Confidence and Cooperation Flexibility and resilience

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

46. Taking 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 Link positive to negative

47. 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 cant use shame to change ourselves or others.

48. 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

49. 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

50. You cant stop the waves, But you can learn to surf. -Jon Kabat-Zinn

51. Learning Model Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence

52. Competence Previous competence as resource Ownership of competence Reframe inadequacy or failure Regrettable moment becomes teachable moment Coherent narrative Find the gift in the mistake

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

54. 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

55. 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

56. 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

57. Linda Graham, MFT lindagraham2@earthlink.net www.lindagraham-mft.net