Neurotheology: Mind/Body Medicine Meets Pastoral Psychotherapy Introduction to Neurotheology, Stress Physiology, Mindfulness, Brain Plasticity, & Psychoneuroimmunology A Format for the Day 9:00 to Break Introduction to Neurothelogy What is Mind/Body Medicine and how does the approach differ from other interventions. The Mind of Jesus, Buddha, and others! Newberg,Beauregaard and others. 10:45 to Noon Brain Plasticity and Psychoneuroimmunology: how can they inform the therapeutic process? Emotional Regulation: is it, at times, a precursor to effective care? What is “down regulation”? Doidge, Schwartz, Davidson and others. Afternoon Sessions 1 to 2:30 pm Neurocardiology and the Polyvagal theory! Is the Heart a part of the mind we’ve failed to attend to? Intro. to Hearmath & emWave Childre, McCraty, Porges, and others. 2:45 to 4 pm Clinical Applications What are Mindfulness Psychology, Buddhist Psychology, ACT, etc. and how to they complement traditional therapeutic modalities? Specific pathologies? When not to use a “mindfulness based approach”? What is Neurotheology? The Brain Store Changing the World One Neuron at a Time? Neurotheology & AAPC In some ways, it was James Ashbrook’s work found in the text of The Human Mind and The Mind of God that opened the doors on neuro-theology. Ashbrook focused on the “bicameral brain”. He was focused on the split activities of the right and left hemispheres of the brain. (Ramachadran quote) His hope: • In 1976, he wandered into the Medical School at the University of Rochester in search of “knowledge about the brain”. Was in asking the question, “How does the brain contribute to knowing the mind of God?” My first interests: My interest in this field began in the early 1970’s through a friend and colleague Samuel Wise, M.D. and Barbara Hulfish, M.D. at the University of Maryland who were investigating “limbic system disorders” using EEG technology to note abnormalities in many presenting psychiatric disorders. They began to successfully treat many different issues with anti-convulsant medication (initially, Dilantin and then Tegretol (carbemezapine) at extremely low doses. Dissertation Topic Changed when my professors at Andover Newton felt it was too “medically focused” So I only included a chapter in my thesis paper on Anxiety Disorders: A Curse or A Call to Wholeness (A Systematic Approach to Diagnosis and Treatment). But I began to read about “The Broken Brain” and the assumption of a shortage of Gamma Amnio Butyric Acid (GABA) in many anxiety patients. I read about the possible relationship of MVP and anxiety disorders (which later lost credence when inverse studies indicated no greater incidence of anxiety in MVP patients than that of the general population. But I was hooked! The next steps on my journey: 17 years in community mental health working side by side with excellent psychopharmacologists. Moving into the field of Oncology and my introduction to psychoneuroimmunology and Mind/Body Medicine! Primarily, at the Henry/Benson Clinic at Harvard Medical School. And the baptism began: Mindfulness Stress Physiology Psychoneuroimmunology Brain Plasticity Neurocardiology Positive Psychology Neuro-theolgoy Introduction Exercise # 1- Form a fist! Hold it for 30 seconds. Stand up, grab hold of the person’s arm next to you, and gently squeeze and shake lightly…….. While yelling, “Let go of me, Let go of me! And yet this is how many of us and our patients live our lives…not unlike our friend Nasurdin and his donkey. Western or Allopathic Medical Approaches Tend to focus on eliminating the external manifestation rather than getting to the latent cause within the organism, such as; 1) Negative or harmful emotional states, 2) Focusing on Positive emotional states, i.e. appreciation and gratitude. Tendency to focus on the Negative It’s good for our survival (especially if you’re a cave “Person”). Built in to focus on negative. 10 things happen in our day….. Continuous flow of thoughts, which we judge as + or - ! How do we know what reality is? Brain is not a very good reality making machine. Mindfulness: What is it? Capacity to be fully conscious and aware. Capacity for sustained moment-to-moment awareness-especially in the midst of turmoil. Andrew Newberg, M.D. UPenn- studies with Tibetan Monks and Franciscan Nuns. It is a discipline? To learn a skill takes practice (dosing), training, like anything else in life. The Brain Hallmarks of Mindfulness Non-judgmental (tough for us neurotics and perfectionists) Acceptance (struggle with reality) Compassion (much better than esteem) Pali word “sati” – means “awareness” & “attention” It is a focus on the NOW Sufi Poet Rumi- We don’t live on that “torture rack of past and future. Past -> <- Future To be in Now Must have and attitude characterized by curiosity, openness and acceptance. Choosing Mindfulness vs. Mindlessness Seems to be our typical state of being- day dreaming, walk into a post…. Multi-tasking….definition: Not doing any ONE thing well or with full engagement! Misconceptions of Mindfulness NOT- blank/empty mind NOT- become emotion-less NOT- withdrawal from life NOT- seeking bliss (might be outcome) NOT- escaping pain. Way of Life Everyday and everything- eating, walking, relationships, vocation, etc. Can and often involves formal meditation (but numerous types… Newberg cites over 20 types). Retreat Choosing Mindfulness vs. Mindlessness Seems to be our typical state of being- day dreaming, walk into a post…. Multi-tasking….definition: Not doing any ONE thing well or with full engagement! Acceptance We usually have an aversion to how we are feeling or behaving: - examples; we want less anxiety, fear, anger, etc. - want to eat less or drink less, exercise more, etc. Begin to Understand: How did we get here? Maxim- Neurons that fire together, wire together. Research Davidson et al @ Univ. of Wisconsin Found increase activity in LPFC after only 9 weeks of mindfulness training (areas that control introspection and attention and are associated with feeling of well-being. TRAINING THE MIND DOES CHANGE THE BRAIN Jon Kabat-Zinn (UMass) “Moment to moment, non-judgmental awareness” “Attentional Control”- redirecting tension to manage emotional distress. Loving-kindness Meditation1) Concentration 2) Mindfulness 3) Loving-kindness The Noble Eightfold Path 1. Right View Wisdom 2. Right Intention 3. Right Speech 4. Right Action Ethical Conduct 5. Right Livelihood 6. Right Effort 7. Right Mindfulness 8. Right Concentration Mental Development Meditation- “to measure” Sanskrit- “samadhi” (sam“mind/placing”, dha- “upon object” Five Obstacles1- Sense desire 2- Ill-will 3- Restlessness 4- Sluggishness 5- Doubt Early Buddhist Text “Whatever a person frequently thinks and ponders upon that will become the inclination of his mind” (Majjhima) Pre-cursor to concept of “brain plasticity” Discovered by Eduard Taub. Constraint Induced Movement Therapy and Tennis????? Contemplative Prayer in Christian Tradition Refer to Father Thomas Keating’s work and history. The Desert Fathers. Meister Eckhart, St. John of the Cross, and monastic tradition! Neurobiology of Mindfulness Higher levels of alpha and theta ban activity in EEG- associated with sleep and rest. 1) Activation of dorsolateral pfc (DLPFC), associated with executive decision making and attention (increased cortical thickening) 2) Activation in Anterior Cingulate Cortexmotor control. Cont. 3) Insula- activate during meditationassociated with interoception- which is sum of viceral and “gut” feelings…one of the things that gives us a feeling. Increased thickening in anterior insula creates interconnections with amygdala. Research- Hozel (2008) “increase gray matter density in the right anterior insula, as well as the hippocampus and left temporal gyrus among mindfulness meditators. Decreases amygdala activity (improves PFC regulation of limbic system response) Known as “Down Regulation” Ability to experience a negative event without getting “caught up” in the event. continued Includes; increased positive affect, Improved immune functioning, Less stress reactivity (may have initial heightened response, but then are able to “let go” and return to a state of calm). Correlated with adaptive regulatory strategies; including acceptance and letting go of negative thoughts.36 Amygdala- Center of Fear Response Which stimulates the hippocampus, AHCHypothalamo-Pituitary-Adrenal (HPA) Axis, and begins cascade of sympathetic ANS response…. Hormones (cortisol, adrenaline),….. And peptides….. Cortisol sends messages to store fat (usually around belly to be easily accessed by the liver). Newberg’s Work at Penn with Tibetan Monks and Nuns Parietal Lobe Changes Psychoneuroimmunology Immune suppression: increases free radicals and oxidative stress, decrease in serotonin, decrease in glucose to the brain. Leads to inflammation* (almost all diseases have inflammatory process). 30-50 Stress responses a day (Harvard Research) Immune functioning Daytime Security- block larger organisms, bacteria/allergic reactions Nighttime Security- block smaller organisms, viruses, tumors…. Systems communicate through cytokines. Normally, at night cortisol is low, but if too high, nighttime security weakness and doesn’t turn off daytime system…thus, we over-react to substances in the environment, Increase in allergies????? Cont. Think of a car traveling at 120 mphoverheats, burns out moving parts….keep the sympathetic and parasympathetic systems on alert all the time. Cellular impact…..chronic low level stressmay be as bad or worse than acute high level stress….recent studies on concussions….etc.. Meditation Breathe (GK- “pneuma”, Hebrew- “ruach” When we control breath we control many of the bodies systems (including heart rate variability…stay tuned). Must begin with “beginner’s mind” (Monk filling cup) Body Scan After becoming aware of breathing, Become aware of any places that you tend to hold tension in your body….you can do this lying down or sitting. Where do you get pain, aches? Guided Imagery Imagine (means to image)….have never created anything without imaging it first.