1. Brain Care is Self Care California Institute of Integral Studies November 1, 2014 Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net 415-924-7765

2. Self Care Exercise Sleep Touch Nature Stress reduction Emotional Health Healthy relationships Meaningful work

3. Brain Care Exercise – grow new brain cells Sleep – housekeeping; consolidate learning Touch – safety and trust; equilibrium Nature – reverie, insights Stress reduction – reduce damage to brain Emotional Health – antidote negativity bias; connect to resources Healthy relationships – develop inner secure base Meaningful work – thriving and well-being

4. 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

5. Brain Care Recover from impact of stress and trauma Rewire automatic habits Resilience and well-b eing

6. Context of Brain Care Evolution of human brain Neuroplasticity Learning and Memory Three Mechanisms of Brain Change Tools to rewire brain for resilience and well- being

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

8. Avoid Brainstem – assess safety-danger Limbic – automatic survival responses Fight-flight-freeze Shut down, numb out, collapse Cortex – strategies for withdrawal, limits and boundaries, defenses

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

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

11. 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 Most integrative structure of brain Evolutionary masterpiece CEO of resilience

12. 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

13. 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

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

15. 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

16. 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.

17. 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

18. 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

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

20. 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

21. Conditioning Brainstem: No! Yes. Limbic: attachment patterns – secure, avoidant, anxious, disorganized, 12-18 months of age Cortex: relational intelligence

22. Relational Intelligence Compassionate listening Setting limits and boundaries Negotiating change Resolving conflicts Repairing ruptures Forgiveness

23. 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

24. 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

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

26. 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

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

28. 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

29. 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

30. 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

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

32. 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

33. Take Mental Breaks Focus on something else (positive is good) Focus for more than a few minutes (flow is good) Talk to someone else (resonant is good) Move-walk somewhere else (nature is good) Every 90 minutes; avoid adrenal fatigue

34. 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

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

36. 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

37. 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 cherished Oxytocin – direct and immediate antidote to stress hormone cortisol

38. 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

39. 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

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

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

42. 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

43. 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

44. Compassion – Self-Compassion Compassion: care and concern in the face of other people’s pain and suffering Self-Compassion: care and concern for one’s own pain and suffering Mindful Self-Compassion: Awareness of experience of suffering Kindness toward self as experiencer of suffering Felt sense of common humanity; all human beings suffer

45. Benefits of Self-Compassion Normalize vulnerability as part of human condition Not weak or selfish; powerful motivator out of care and wishes for well-being Less anxiety, depression, stress, rumination, shame, fear of failure Greater responsibility for past mistakes More self-confidence and resilience

46. 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

47. 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

48. Emotions Signals to take action Adaptive action tendencies Anger – protest injustice, betrayal Sadness – pull in comfort Fear – move away from danger, toxicity Guilt – healthy remorse, make amends Joy – expand, connect with others

49. 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

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

51. 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

52. 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

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

54. 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

55. 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

56. 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

57. Insecure-Avoidant Parenting is indifferent, neglectful, or critical, rejecting Attachment is avoidant of people and emotions, withdrawn, compulsively self-reliant Stable, but not flexible Focus on self or world, not others or emotions Rigid, defensive, not open to learning Neural cement

58. Insecure-Anxious Parenting is inconsistent, unpredictable Attachment is clingy, needy, compulsive caregiving Flexible, but not stable Focus on other, not on self-world, Less able to retain learning Neural swamp

59. Disorganized Parenting is frightening or abusive, or parent is “checked out,” not “there” Attachment is paralysis, fright without solution Lack of focus Moments of dissociation Compartmentalization of trauma

60. Relational Intelligence Compassionate listening Setting limits and boundaries Negotiating change Resolving conflicts Repairing ruptures Forgiveness

61. Compassionate Listening Resonance – vibe of person Attunement – felt sense of emotions Empathy – make sense of story Compassion – care about the experiencer Acceptance – “Given what happened, of course you would feel/behave the way you do.”

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

63. 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

64. 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

65. 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

66. 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

67. 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.

68. 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.

69. 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.

70. 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.

71. 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

72. Mindfulness – Observing Ego Pause, become present Notice and name Step back, dis-entangle, reflect

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

74. Mindfulness-Observing Ego Catch the moment; make a choice Shift perspectives; shift states Discern options Choose wisely – let go of unwholesome, cultivate wholesome

75. Flow Spacious awareness; timelessness Absorption in process Balance between stress and boredom

76. Multi-tasking Focused attention – brain works well Spacious awareness – brain works well Multi-tasking Switching attention requires metabolic energy Switching fatigues brain Brain becomes tired, confused, foggy

77. 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.

78. 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.

79. 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.

80. 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

81. 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

82. Learning Model Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence

83. 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

84. 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.

85. Nutrition Eat more Protein Vegetables Supplements Eat less Caffeine Sugar Allergens

86. Laughter Reduces cortisol; lowers blood pressure Increases oxygen and blood flow; reduces risk of heart disease and stroke Triggers catecholamines; brightens the mind Promotes productivity, creativity, problem-solving Reduces mistakes; promotes efficiency

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

88. 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

89. 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

90. Brain Care is Self Care California Institute of Integral Studies November 1, 2014 Linda Graham, MFT linda@lindagraham-mft.net www.lindagraham-mft.net 415-924-7765