MINDFULNESS MEDITATION & NEUROSCIENCE PROFESSOR ROB MACFADDEN, UNIVERSITY OF TORONTO INSPIRE TO REWIRE Continuing Education Factor-Inwentash Faculty of Social Work University of Toronto October 31st, November 1st, 2014 1 Training Video on the Brain • http://www.youtube.com/watch?v=snO68a JTOpM 2 MINDFULNESS MEDITATION & NEUROSCIENCE NEUROSCIENCE AS A NEW PARADIGM Demise of the mind-body split (Descarte’s Error) Move towards integration (Mind/Body) Biological/Psychological/Social Beings Rise of nurture (e.g., environment, social, psychological, lifestyle) Neuroplasticity and self-directed neuroplasticity Mental health therapists as physical agents impacting the brain, body & emotions of others 3 MINDFULNESS MEDITATION & NEUROSCIENCE NEUROSCIENCE AS A NEW PARADIGM Characteristics of the brain have a big impact on how we function Some of the problems we experience & work with are a function of the structure & operation of the brain Understanding the brain/body connection can reduce blame/sense of personal failure (normalize) and engage the client in intervention (e.g., hand puppet of the brain) 4 MINDFULNESS MEDITATION & NEUROSCIENCE An Introduction to the Brain Some Brain Facts: The brain is the most advanced and complex organ in our known universe. 1. The human brain has about 100,000,000,000 or 100 billion neurons. From the age of 35 years about 7000 neurons are lost daily. 2. During early pregnancy the neurons in the fetus can multiply at a rate 250,000 neurons/minute. 3. Brain is composed of 75 to 80% water. Dehydration can affect proper functioning of brain. 4. Brain consists of 60% White matter and 40% Grey matter. White is the supporting matter and Grey is the thinking matter of the brain. If the brain was a computer the grey matter would be the computer itself and the white matter its cables. 5 MINDFULNESS MEDITATION & NEUROSCIENCE Some Brain Facts (Cont’d): 5. Adult brain weighs about 3 pounds or 1300 to 1400 Grams. This is about 2% of the body weight if you weigh 150 pounds or 70 kgs. 6. Although the brain only accounts for 2 percent of our body weight but it consumes 20% of the oxygen that we breathe and roughly 20 percent of our daily calories. 7. 15-20% of all blood pumped out of the heart goes directly to the brain. 8. All the thinking in the brain is about electricity and chemicals. The brain is more active and thinks more at night than during the day. From: http://www.medindia.net/health_statistics/health_facts/brain-facts.htm 6 MINDFULNESS MEDITATION & NEUROSCIENCE There is so much stimuli coming into our senses. It is estimated that our five senses are receiving more than 11 million pieces of information per second. It is believed we can handle about 40 pieces of information per second consciously (Wilson, 2002). More of these stimuli are being processed by our unconscious but most of the incoming stimuli are not attended to consciously or unconsciously. Thus there is enormous competition for our attention. Items that are novel, or which threaten our survival or present opportunities for survival or those which elicit emotions are marked for attention and memory. 7 MINDFULNESS MEDITATION & NEUROSCIENCE 8 MINDFULNESS MEDITATION & NEUROSCIENCE From Hanson, R. (2009). Buddha’s Brain. 9 MINDFULNESS MEDITATION & NEUROSCIENCE From Hanson, R. (2009). Buddha’s Brain. 10 MINDFULNESS MEDITATION & NEUROSCIENCE Anatomy of a neuron and a synapse from “Brain Facts” of the Society for Neuroscience, http://www.brainfa cts.org/AboutNeuroscience/Brai n-Facts-book 11 MINDFULNESS MEDITATION & NEUROSCIENCE REAL TIME VISUALIZATION OF NEURONAL FIRING http://www.dailymail.co.uk/sciencetech/article2581184/The-dynamic-mind-Stunning-3D-glass-brainshows-neurons-firing-real-time.html 12 MINDFULNESS MEDITATION & NEUROSCIENCE http://www.youtube.com/watch?v=DDlfP1FBFk “FLIPPING YOUR LID” Dan Siegel’s Brain Hand Puppet from Siegel & Hartzell (2003), Parenting from the inside out. P.173 13 MINDFULNESS MEDITATION & NEUROSCIENCE TRIUNE BRAIN The brain has developed over millennia and this history influences who we are today. The brain is an archeological record. (Triune Brain by Paul MacLean) In general terms, the brain can be seen in terms of three evolutionary components: The reptilian brain was the first core to develop and is basic life sustaining, controlling key functions such as respiration, circulation, the endocrine system, reproduction, arousal & homeostasis. Much is reflexive and drive based- fear, rage, eating, and mating which still retains a degree of control over our actions. (Brainstem) 14 MINDFULNESS MEDITATION & NEUROSCIENCE TRIUNE BRAIN The paleomammalian brain was added on and brought with it learning, memory and emotion. (Limbic system) The neomammalian brain was a third addition and brought enhanced cognition, enhanced social connection and sense of self and selfawareness. Problem-solving was enhanced and an increased emphasis on social connection enabled us to organize into larger communities, to increasingly plan ahead and to learn more from experience. (Neocortex) 15 MINDFULNESS MEDITATION & NEUROSCIENCE TRIUNE BRAIN Louis Cozolino describes psychotherapy in “It’s a Jungle in There” (Psychotherapy Networker 2008 September/October) is like working with an anachronistic menagerie- a human, a horse and a crocodile within the same body. Our skull shares its space with ancient brain equipment and our functioning requires integrating and coordinating these highly specialized and complex systems. These areas of our brain can vie for dominance and experience conflict with each other without us being conscious of this. 16 MINDFULNESS MEDITATION & NEUROSCIENCE Cozolino & Santos (2014, p.157) remark that, Due to their very complexity, our brains are extremely vulnerable to dysregulation, dissociation and emotional distress. Cozolino notes that the inherent weaknesses of our brain provides helpers (like social workers) with a form of job security. The authors also note that …adding a neuroscientific perspective to our clinical thinking allows us to talk with clients about the shortcomings of our brains instead of a problem with theirs (p. 175). 17 MINDFULNESS MEDITATION & NEUROSCIENCE 18 MINDFULNESS MEDITATION & NEUROSCIENCE Bi-Lateral Integration (LEFT BRAIN AND RIGHT BRAIN) The right mode of processing: A.Holistic – things are perceived in the whole of their essence. B.Visuospatial – the right side works well with seeing a picture and is not proficient at decoding the meaning of words. C.Non-verbal – eye contact, facial expression, tone of voice, posture, gestures, and timing and intensity of response are the non-verbal components of communication that the right mode both sends and perceives from others. D.A wide range of functions, including the stress response, an integrated map of the whole body, raw, spontaneous emotion, autobiographical memory, a dominance for the non-verbal aspects of empathy. The right mode has no problem with ambiguity and is sometimes called “analogic” meaning it perceives a wide spectrum of meaning, not just a digital restricted definition of something. 19 MINDFULNESS MEDITATION & NEUROSCIENCE http://www.youtube.com/watch?v=xPjhfUVgvOQ&feature=related Siegel: Integrating the two hemispheres Bi-Lateral Integration (LEFT BRAIN AND RIGHT BRAIN) The left mode of processing: A.Linear – the left loves this sentence, one word following the next. B.Logical – specifically syllogistic reasoning in which the left looks for cause-effect relationships in the world. C.Linguistic – these words are the left’s love. D.Literal – the left takes things seriously. In addition, the left is sometimes considered the “digital” side, with on-off, yes-no, right-wrong patterns of thinking. 20 MINDFULNESS MEDITATION & NEUROSCIENCE LOW ROAD & HIGH ROAD 21 MINDFULNESS MEDITATION & NEUROSCIENCE LOW ROAD & HIGH ROAD Emotions are bodily responses that evolved to ensure our survival and they are at the core of who we are and that they reflect “…prepackaged decisions of great complexity (LeDoux, 1996)”. If something induces fear, for instance, the sympathetic nervous system is activated and a cacophony of biochemical agents, and bodily changes designed to “fight or flight” occur rapidly. An emotional reaction can occur even before the person is consciously aware of the threat. This immediate, “low road” to arousal has significant survival value. It is extremely rapid and doesn’t require cognitive reflection and delay. Emotions use the brain’s “superhighway” (Jensen, 2008a) to ensure that emotions get our priority. Emotions can overpower cognition as we move from reflection to reaction. A high state of arousal can be a form of “emotional hijacking” (Sprenger, 2007) and make it difficult to remember and to think. Negative emotions, past a point, narrow our scope of attention and thinking (Sousa, 2006). 22 MINDFULNESS MEDITATION & NEUROSCIENCE GAS PEDAL AND BRAKES Emotional regulation is a critical process in maintaining well-being and mental health. Our brain contains processes alternatively described as accelerators and brakes. The sympathetic nervous system (SNS) (fight or flight) is an example of a systemic accelerator that puts our mind and body on a war footing. Our blood pressure increases, pupils dilate, muscles tense, our mental focus sharpens as the brain and body are dosed in cortisol & other brain chemicals. This is the gas pedal. The brake is our parasympathetic nervous system (PNS) which downshifts the SNS and begins the relaxation process. Blood pressure decreases, our breathing becomes normal and we are able to think and problem-solve more easily. Time-outs, medications, deepbreathing, meditation, self-hypnosis are examples of other brakes. Self-soothing & soothing by others are other types of brakes. Continual fear, anxiety and arousal initiates the SNS & soaks our system with cortisol and leads to states of hyper vigilance with a hyperactive amygdala, an easily aroused SNS. More “low road” processing occurs, & emotional regulation becomes very difficult. Chronic cortisol exposure can shrink our hippocampus & make thinking & remembering 23 difficult. MINDFULNESS MEDITATION & NEUROSCIENCE Neural Circuitry: We’re all electricians. Circuits are being formed, weakened, strengthened, and purged. Experience is like a scalpel. Much happening unconsciously and may be consciously driven. Meditation is an act of circuit building- if you have an awareness of this, then it’s a conscious act of circuit building.The ability to control and to direct your attention is essential to well-being. It is the core of emotional regulation. Secret to deliberate circuit building: paying attention. Intentional attention. The ability to connect with, attune to, and help build new neural connections at the heart of psychotherapy. We are all gardeners, helping each other manage and grow our gardens. 24 MINDFULNESS MEDITATION & NEUROSCIENCE Reacting to Challenges: the Autonomic Nervous System: Stephen Porges & the Polyvagal Theory Excerpted from stephenporges.com Neuroception describes how neural circuits distinguish whether situations Porges believes our nervous system is in a constant quest for safety. 25 MINDFULNESS MEDITATION & NEUROSCIENCE Stephen Porges’ Polyvagal Theory Nervous System’s Quest for Safety ENVIRONMENT OUTSIDE THE BODY INSIDE THE BODY NERVOUS SYSTEM NEUROCEPTION SAFETY DANGER Spontaneously engages others Eye contact, facial expression, prosody, supports visceral homeostasis LIFE THREAT Defensive strategies Death feigning, shutdown, immobilization Social Engagement System Defensive strategies Fight/flight behaviors (mobilization) 26 MINDFULNESS MEDITATION & NEUROSCIENCE SEEKING SAFETY This new vagal circuit also inhibits heart rate and arousal. It shares a pathway that co-ordinates the nerves controlling the muscles in the face and head. So people are literally showing their heart on their face. This circuit impacts our voice and middle ear muscles. To calm a person you need to smile and talk to them in a soothing (i.e., prosodic) way. Clinicians need to appreciate the importance of creating safety in our work. Avoid low frequency sounds (predators) such as ventilation systems and traffic sounds. Explore what kind of seating feels safe or comfortable. 27 MINDFULNESS MEDITATION & NEUROSCIENCE Critical Discovery in Neuroscience? Neuroplasticity and Neurogenesis Neuroplasticity is the brain’s ability to reorganize by creating new neural connections over the lifespan. Neurogenesis is the process by which new neurons are generated. 28 MINDFULNESS MEDITATION & NEUROSCIENCE Definition: Non-judgmental attention to experiences in the present moment (Kabat-Zinn, 1990). Involves attention on the experience of thoughts, body sensations, emotions and observing them as they arise and go away. Two central components: (1 ) regulation of attention to keep it on the immediate experience; (2) approaching experiences with curiosity, openness, and acceptance, regardless of whether they are positive or negative. 29 MINDFULNESS MEDITATION & NEUROSCIENCE THE POWER OF INTENTIONAL ATTENTION Attention resembles a spotlight, illuminating what it rests upon (Hanson) Consciousness may play a direct role in harnessing neural plasticity by altering previously automatic modes of neural firing and enabling new patterns of neural activation to occur. Attention directs change. The basic steps linking consciousness with neural plasticity are as follows: Where attention goes, neural firing occurs. And where neurons fire, new connections can be made. Directing attention purposefully shapes the brain and impacts one’s life. Most neuroplasticity is incremental, not dramatic Neuroplasticity is double-edged- can work for or against you. 30 Video • Stroke of Insight by Dr. Jill Bolte Taylor on TED. • http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight.html 31 MINDFULNESS MEDITATION & NEUROSCIENCE Explicit & Implicit Mental Processing Systems THE NEW UNCONSCIOUS Two mental processing systems which involve: memory; perceptions; learning; emotions; action control; motivation; emotional regulation & interpersonal behaviour. Explicit processing system is the conscious one which is that part of us that we believe is who we are. It involves us consciously perceiving things, remembering things like facts, events, and being aware of how we feel and being conscious of taking action. It provides the history for the development of our selfidentity. 32 MINDFULNESS MEDITATION & NEUROSCIENCE Implicit Mental Processing System • Most fundamental & occurs outside our awareness; • We are much more about unconscious processes, yet we view ourselves mostly as conscious creatures; • Our 5 senses are estimated at receiving more than 11 million pieces of information per second. We don’t have enough conscious processing power or capacity to manage this. • Our unconscious allows us to manage fundamental processes (e.g., heart beat, walking, eating, drinking) without engaging our consciousness. Life would be impossible without our unconscious processing. 33 Explicit & Implicit Mental Processing Systems Adaptive Unconscious Conscious Multiple Systems, different areas of brain Single system Older Younger Less easily disrupted Easily disrupted Here and Now orientation More future oriented Faster Slower, check and balance Automatic Non-automatic, deliberate More rigid Less rigid Uncontrollable Controllable Categorization Less categorization Unintentional Intentional Great pattern detector Less great pattern detector, slower More sensitive to negative information More sensitive to positive information Slow to respond to contradictions Responds faster to contradictions Quick appraisals- sees things quickly Slower appraisals 34 MINDFULNESS MEDITATION & NEUROSCIENCE Implicit Mental Processing System Implicit memories occur from birth on & contain emotional memories, learnings & knowledge that have accumulated over a lifetime. Knowledge is marked through emotions with positive or negative valences. We remember things that help us achieve goals and things that do not or that threaten our survival. Most of our knowledge is implicit & most of our decisions are made beyond our awareness. Our implicit system has speedy ways of analyzing & making decisions. These approach/avoid learnings help us to work through the mass of problem-solving we do each day. 35 MINDFULNESS MEDITATION & NEUROSCIENCE Implicit Mental Processing System • Not all the implicit knowledge is good or accurate. The valences are like biases towards and away from knowledge, so biases are normal and lifesaving. However some biases are incorrect and can promote stereotyping & prejudice. Some of the learning can be faulty & destructive. Because this knowledge is below our awareness, we may act on these beliefs without knowing. • Researchers from Harvard and the Universities of Virginia and Washington have been exploring these implicit biases through the Implicit Association Test (IAT) & developing ways to identify them. Visit http://www.tolerance.org/activity/test-yourself-hidden-bias to explore some of your own. 36 MINDFULNESS MEDITATION & NEUROSCIENCE Taken directly from “Why we need therapy- and why it works: A neuroscience perspective”. L. Cozolino and E. Santos (2014, Smith College Studies in Social Work, 84: 157-177) The difference between the fast implicit system (10-50 ms) and the slower explicit system (500-600 ms) is called the ‘vital half second’ and is an ‘eternity’ for neural connections. Ninety percent of the input to the cortex comes through the fast, internal implicit system. The half second difference gives our brains the opportunity to construct present experience based on a template from the past. By the time we are aware of an experience, our brain has processed it many times, activating complex patterns of behaviours and activated memories. We feel we are living in the present when we are living a half second behind. This is a projective process that is meant to be helpful in predicting the present and future from the past, but it can lead to misunderstandings and problems in perceiving and evaluating things including relationships. 37 MINDFULNESS MEDITATION & NEUROSCIENCE 38 MINDFULNESS MEDITATION & NEUROSCIENCE Mindfulness Research See Mindfulness Research Handout 39 MINDFULNESS MEDITATION & NEUROSCIENCE • • • • • Physical Impact of Meditation Enhances immune system Reduces stress-related cortisol Increases activation of left frontal regions which lifts mood Thickens & strengthens frontal cingulate cortex & insula Enhances attention, empathy & compassion (Hanson, 2009) http://www.youtube.com/watch?v=m8rRzTtP7Tc Neuroscientist, Dr. Sara Lazar 40 MINDFULNESS MEDITATION & NEUROSCIENCE Mindful Brain by Daniel Siegel (2007) Mindfulness implies a healthy relationship with oneself. It involves intrapersonal attunement (p.XIV). Attunement involves focusing attention on the internal world of the other. In this case, it is focusing on your own internal world. Interpersonal attunement allows two people to “feel felt” by each other. Attuned relationships promote resilience and longevity. Mindful awareness is a form of self-relationship and an internal form of selfattunement. It causes neuroplasticity or a change in neural circuits. Paying attention to the present moment improves the functioning of the body, brain and relationships. It harnesses the social circuitry of the brain to develop an attuned relationship within our own mind. 41 MINDFULNESS MEDITATION & NEUROSCIENCE Mindful Brain by Daniel Siegel (2007) Similar outcomes in attachment process and in mindfulness meditation: both associated with changes in pre-frontal cortex. Pre-frontal cortex is integrative & contains long strings of neurons that reach out to many brain centres. The functions below correlate with the activity of the middle areas of the prefrontal cortex. Changes to the pre-frontal cortex through meditation aid in: Regulation of body Balancing emotions Attunement to others Modulation of fear Responding flexibly Exhibiting insight Mindfulness aids in being in touch with intuition and morality. 42 MINDFULNESS MEDITATION & NEUROSCIENCE Mindful Brain by Daniel Siegel (2007) mindful awareness helps to: Developing Regulate emotion & combat emotional dysfunction Improve thinking Reduce mindsets Reduce stress Enhance immune system and physical well-being Improves the ability to perceive others’ emotions Improves ability to sense world of others Promotes capacity for intimate relationships, increased resilience & well being. 43 MINDFULNESS MEDITATION & NEUROSCIENCE Mindful Brain by Daniel Siegel (2007) promotes a shift of brain function to left frontal dominance in Mindfulness response to emotional triggers. Left frontal dominance is associated with approach orientation and more positive emotion. This shift correlated with improved immune system functioning. Increased thickness of middle pre-frontal area, bilaterally and thickening of the insula, particularly on the right side. Thickness correlated with time spent practicing mindfulness. Compassion meditation seems to increase co-ordination of firing in the pre-frontal area for both sides of the brain. 44 MINDFULNESS MEDITATION & NEUROSCIENCE SOCIAL BRAIN There are no “single” brains. Humans are social to the core; the mind is both embodied and relational. Human development and maturation is the longest of all the mammals; infant and parent are an inseparable dyad, parent-infant. We need considerable “home assembly”. Brain maturation occurs into the twenties. Brain development occurs throughout a lifetime. Social relatedness is structured by neural networks of bonding and attachment, play, predicting other’s behaviours and feeling the feelings of others. At birth, baby set up to encourage social connections through reflexes such as grasping, eye contact and following. It makes them cuddly and attractive to kick start bonding and attachment. 45 MINDFULNESS MEDITATION & NEUROSCIENCE SOCIAL BRAIN Attachment = Survival Abandonment = Death Infant and children use their parents’ prefrontal lobes as an external prosthetic to help them regulate their emotions (Cozolino, 2006) Attachment involves the creation of feelings and perceptions connected with self and other and includes evaluation of the worth of self and other and whether other people are predictable, safe and encouraging or unpredictable and dangerous. Baby is now being seen as an important agent (not just passive) in the attachment resonance. Neurochemical cascade between parents and baby including endorphins, dopamine which rise and fall with touch and separation. 46 MINDFULNESS MEDITATION & NEUROSCIENCE SOCIAL BRAIN Infant looks at parent’s eyes and can see calm or anxiety. Parent’s realities and unconscious experiences are transferred to child. Right brain (parent) to right brain (mother) communication, much unconscious, especially during the earliest years. Dr. Ed Tronic’s “Still Face” Experiment https://www.youtube.com/watch?v=apzXGEbZht0 Biochemistry of Social Motivation (From Cozolino, 2006, p.121) Androgen and estrogen Testosterone Dopamine Norepinephrine & Serotonin Oxytocin & vasopressin Endorphins Sex drive Monogamy & paternal behaviour Attraction Well-being, reward prediction Attachment, nest building, nursing, anxiety reduction Affiliation, maternal behaviour, sexual arousal, social reward, play behaviour, down-regulates 47 anxiety MINDFULNESS MEDITATION & NEUROSCIENCE SOCIAL BRAIN 48 MINDFULNESS MEDITATION & NEUROSCIENCE http://www.youtube.com/watch?v=V9H1eEXzbPM&feature=related Mirror Neuron System Knowing you, knowing me, knowing you. Considered the root of empathy. Allows us to map the mind of others. Mirror neurons respond to acts with intention or purpose. Includes any act in others you can predict (unconsciously) from experience. Automatic. Hardwired to detect sequences and make maps in our brains of the internal states of other people. Cross modal: operates on all sensory levels. A sound, touch or smell can cue us to the internal state of another. Through embedding the mind of another in our firing patterns, this forms the basis of our mindsight maps. Not only behavioural intentions of others but emotional states of others. We come to resonate with the emotional states of others. 49 MINDFULNESS MEDITATION & NEUROSCIENCE A Neural circuit called the insula is the information superhighway between the mirror neurons and the limbic system. The Insula processes pain, taste, sequences speech movements and helps to translate unconscious emotions into conscious feelings. It is is believed that we make maps of intentions through the mirror neurons and then transfer this information downward to subcortical (e.g., limbic and brainstem) regions. These signals from our body, brainstem and limbic areas then travel upwards to our middle prefrontal areas. Pathway: Mirror neurons to subcortical areas to middle prefrontal areas. This is the pathway that connects people to each other. When received by the middle prefrontal cortex, a map is made of our internal world. We feel others’ feelings by actually feeling our own. People who are more aware of their own body feelings have been found to be more empathic. When we can sense our own internal state the pathway for resonating with others is open as 50 well. MINDFULNESS MEDITATION & NEUROSCIENCE Mirror Neuron System For example, the mirror neuron system is thought to be an essential aspect of the neural basis for empathy. By perceiving the expressions of another individual, the brain is able to create within its own body an internal state that is thought to “resonate” with that of the other person. Resonance involves a change in physiologic, affective, and intentional states within the observer that are determined by the perception of the respective states of activation within the person being observed. One-to-one attuned communication may find its sense of coherence within such resonating internal states. The clinical implications of this work are profound and help therapists to understand not only the inherently social nature of the brain but that their own bodily shifts may serve as the gateway toward empathic insights into the state of another person. Mediated via the insula, perceptions of another’s affective expressions may alter our own somatic and limbic states and then be examined through a prefrontal process of interoception, interpretation, and attribution to another’s states. 51 MINDFULNESS MEDITATION & NEUROSCIENCE Mirror Neuron System Being open to our own bodily states as therapists is a crucial step in establishing the interpersonal attunement and understanding that is at the heart of interpersonal integration. Such interactive experiences allow the patient to “feel felt” and understood by the therapist, and they also may establish new neural net firing patterns that can lead to neural plastic changes. 52 MINDFULNESS MEDITATION & NEUROSCIENCE Mirror Neuron System Mirror neurons reveal the fundamental integration within the brain of the perceptual and motor systems with limbic and somatic regulatory functions. The mirror neuron system also illuminates the profoundly social nature of our brains. This social basis of neural function may offer new pathways for us to understand how psychotherapy leads to the process of change. When two minds feel connected, when they become integrated, the state of firing of each individual can be proposed to become more coherent. Literally this may mean that the corresponding activations between the body-proper, limbic areas and even cortical representations of intentional states between two individuals enter a state of “resonance” in which he matches the profiles of the other. The impairment of such shared states has been proposed to be a characteristic of forms of psychopathology, including schizophrenia. Recent studies in individuals with autism spectrum disorder reveal impairment in the capacity to perceive emotional expressions in others that is associated with markedly diminished mirror neuron activation. With impaired mirror neuron system functioning, the social brain is unable to share in the rapid social interactions that reflect modern life. 53 MINDFULNESS MEDITATION & NEUROSCIENCE Mirror Neuron System In the process of psychotherapy involving a range of individuals with intact mirror neuron systems, shared states with the therapist may be an essential component of the therapeutic process. As two individuals share the closely resonant reverberating interactions that their mirror neuron systems make possible, what before may have been unbearable states of affective and bodily activation within the client may now become tolerable with conscious awareness. Being empathic with patients may be more than just something that helps them “feel better” – it may create a new state of neural activation with a coherence in the moment that improves the capacity for self-regulation. What is at first a form of interpersonal integration in the sharing of affective and cognitive states now evolves into a form of internal integration in the patient. With the entry of previously warded-off states of being in conscious awareness, the patient can now learn to develop enhanced self-regulatory capacities that before were beyond his/her skill set. It may be that as interpersonal attunement initiates a new form of awareness that makes intrapersonal attunement possible, new self-regulatory capacities become available. 54 NEUROSCIENCE & SOCIAL WORK PRACTICE Mirror Neuron System If the mirror neuron system were to be focused on one’s own states of mind, we can propose that a form of internal attunement would allow for new and more adaptive forms of self-regulation to develop. The practice of focusing attention in the present moment on one’s own intentions and somatic states, such as the breath, have been a mainstay of mindful awareness practices over thousands of years. A “Mirror Neuron-Mindfulness Hypothesis” can be offered that proposes that the focusing of one’s non-judgmental attention on the internal state of intention, affect, thought and bodily function may be one way in which the brain focuses inward to promote well-being. As the therapist attempts to achieve such an open, receptive state of awareness toward both internal state changes and for interpersonal signals sent by the patient, the patient’s own mind may be offered the important social experiences to create a similar state. In this way the mirror neuron system may serve a powerful role as the neural basis of mental attunement within and between both patient and therapist. 55 MINDFULNESS MEDITATION & NEUROSCIENCE EMOTIONS In neuroscience, emotion and feelings are related but different. Antonio Damasio, a distinguished neuroscientist views emotions as playing out in the theatre of the body. Emotions are bodily responses that evolved to ensure our survival and they are at the core of who we are and that they reflect prepackaged decisions of great complexity (LeDoux, 1996). See DVD on emotions/feelings Damasio views feelings as occurring in the theatre of the mind, after emotional arousal begins. He believes that emotion, feeling and biological regulation are all in the “loop” of high reason. Damasio (2003, p. 86) describes a feeling as “…the perception of a certain state of the body along with the perception of a certain mode of thinking and of thoughts with certain themes.” 56 MINDFULNESS MEDITATION & NEUROSCIENCE EMOTIONS These feelings can occur unconsciously or consciously, although feelings which are conscious have longer lasting impacts on the conscious mind. Indeed, we may owe our fundamental sense of consciousness to our ability to be aware of our feelings. Damasio believes we know that we are experiencing an emotion when the sense of a feeling is created in our minds resulting in the sense of a feeling self (Damasio, 1999, p.279). Emotions are central to integration (well-being). Emotion is an active process that shifts our state of integration. Emotions link neural pathways into a functioning whole or state of mind. (Siegel) http://www.youtube.com/watch?v=1wup_K2WN0I&feature=related Sharing affective states is a fundamental form of integration. 57 MINDFULNESS MEDITATION & NEUROSCIENCE EMOTIONS Recall again that Mindfulness is believed to help with reappraisal of a stimulus which may short-circuit some of the stress response. All emotions are welcomed and accepted which may help to reduce the negativity pairing. Mindfulness helps to increase positive mood, lower rumination. With a more positive mood set, Mindfulness can help with emotional regulation, pairing negative emotions with calm, positivity, leading to some extinction and reconsolidation with a less toxic context to the emotion. Mindfulness enhances awareness of bodily sensations associated with emotion which is essential in experiencing feelings. Being more aware of emotions and feelings can assist with emotional regulation. Siegel notes that naming a feeling can help to tame the feeling. (Amygdala arousal is frequently reduced when the left hemisphere names the feeling). 58 MINDFULNESS MEDITATION & NEUROSCIENCE POSITIVE EMOTIONS See handout, “Buddha’s Brain” by Rick Hanson (2009) Brain has a negativity bias, it is important to balance with positive emotions Note and savour positive experiences. Pay attention and collect them Focus on your emotions and body sensations. Fill your body with these positive emotions and marinate in the sensations Positive emotions can be used to soothe and balance negative experiences Associating painful feelings with positive emotions can reduce the impact of negative feelings. The painful feelings expressed within a caring and loving relationship, for example, can reduce the pain and change the intensity of the memory. 59 MINDFULNESS MEDITATION & NEUROSCIENCE H-E-A-L PROCESS Have- you have the positive experience – notice one or create one Enrich. Increase duration, intensity, multimodality (bring into body, sit up proudly), Novelty heightens learning and increase personal relevance. Absorb. Visualize it sinking in, sense it, build it. Link. (optional). Hold positive feelings or thoughts or memories in awareness and introduce some painful thoughts, feelings, etc. (natural antidote). 60 MINDFULNESS MEDITATION & NEUROSCIENCE The positive material will gradually associate with the negative material, soothing, easing and eventually replacing it. Have more episodes over the day, even 30 seconds at a time, half dozen times a day. Dozen or so seconds each time. Will turn activated states into traits eventually. It is startling to realize how unwilling the mind is to give the gift to oneself of a positive experience (Hanson). See the new book by Rick Hanson (2013), “Hardwiring happiness: The new brain science of contentment, calm and confidence”. NY: Harmony Books. 61 MINDFULNESS MEDITATION & NEUROSCIENCE Let us be grateful to people who make us happy. They are the charming gardeners who make our souls blossom. Marcel Proust 62 MINDFULNESS MEDITATION & NEUROSCIENCE Interpersonal Neurobiology: A Brain-Based Approach The term “Interpersonal Neurobiology” coined by Daniel J. Siegel (1999) in his book, The developing mind: How relationship and the brain interact to shape who we are. NY: Guilford Press. Scientific grounded paradigm of Neural Integration. Health and well-being defined as neural integration. Individual well-being and supportive relationships come from brains that are more integrated. An integrated mind reflects FACES: Flexible, Adaptable, Coherent, Energized and Stable. Triangle of Well-Being Relationships (how we share energy & information) Mind Brain (regulates flow of energy & information) (mechanisms by which energy & flow is regulated) 63 MINDFULNESS MEDITATION & NEUROSCIENCE Well-Being An interpersonal neurobiology (IPN) perspective of mental well-being views the mind as achieving self-organization by balancing the opposing processes of differentiation and linkage. When separated areas of the brain are allowed to specialize in their function and then to become linked together, the system is said to be integrated. This coherent flow is bounded on one side by chaos and on the other by rigidity. In this manner we can envision a flow or river of well-being, with the two banks being chaos on the one side, rigidity on the other. This flow of well-being can be seen to reveal the correlations among an empathic relationship, a coherent mind, and an integrated brain as three points on a triangle depicting well-being. 64 Social Work Practice in the Time of Neuroscience Siegel defines the mind as an embodied and relational process that regulates the flow of energy and information. Regulation is central to mental life, and helping others with this regulatory balance is fundamental to understanding how the mind can change. Goal is to promote mental health and well-being. Key is promoting flow (versus chaos and rigidity) and integration (i.e., everything working together individually, and in harmony). Triangle of well-being: Empathic relationships, healthy mind and integrated brain. An Integrated brain, coherent mind, empathic relationships Daniel J. Siegel 65 MINDFULNESS MEDITATION & NEUROSCIENCE Brain and Learning Findings Implications for Therapy Content needs to make sense to learners The therapist’s model has to make sense in explaining the client’s situation. This increases a sense of bond and optimism. Content has to be relevant The goals have to be the clients’ goals. They have to be owned and important. Identifying and working on relevant goals strengthens the therapist’s connections with clients. Working on a problem should always involve an important approach goal. Relevance activates emotions. Emotions drive attention & memory Therapist needs to work with emotions of clients to engage motivation and to explore underlying feelings and to develop attachment. Client needs to feel felt. A positive alliance is built on positive emotions. Action is important in learning Doing things strengthens new & existing neural connections. Encourage clients to try things out, homework, role playing, drawing, writing, etc. Multi-sensory experiences improve memory and utilization When possible, engage clients in different sensory ways through use of images, sound, video. The use of rich metaphors which activate thinking, imagination and feelings use multi-sensory connections. Learning optimized through relaxed attention, avoiding excessive stress & anxiety. While some level of stress improves motivation, clients should also feel safe and secure to be open and to share feelings & thoughts. This will improve both making & retrieving memories, & thinking abilities. Encouraging Mindfulness Meditation, self-hypnosis & other ways to relax and to regulate attention & emotion may be useful. 66 MINDFULNESS MEDITATION & NEUROSCIENCE Brain and Learning Findings Implications for Therapy Build on existing learner’s knowledge & beliefs. Start where client is at. This involves understanding the client’s world view’s, beliefs & preferences & building from there. Previous learnings, preferences are already part of the client’s understanding. New learnings that connect with these pre-existing realities are easier to build on and will likely be accepted, acted on, and prevail. Foster positive emotions to aid in thinking and remembering While first acknowledging & listening to client’s problems, move quickly to generate positive emotions. A strong, positive alliance, discussion of strengths and solution talk, positive life/relationship review, relaxation training, positive imaging, increasing social support can improve the client’s experience of positive emotions. Work to develop learning at the conscious and unconscious levels Besides working consciously on challenging & refining client beliefs & ideas, consider exploring ways to impact implicit knowledge such as use of metaphor, experiences without discussion (right brain to right brain), vigorously interrogating unconscious beliefs and substituting positive conscious beliefs. Change in psychotherapy can happen in at least two ways: working at the implicit level to promote change at the explicit level of functioning (e.g., the attunement within a positive attachment relationship leads to a conscious change in the client’s positive self-evaluation or a conscious CBT focus on self-worth leads to unconscious changes in the self-worth schema within the right brain). Encourage deep learning: memory & retrieval, analysis, critique, action, feedback and refinement Clients need to process new learning. Explore it, try it out, refine it, continually use it. Have others support it. Develop new stories that support the positive changes. This is deep processing of change that is more like to promote and maintain desired changes. 67 MINDFULNESS MEDITATION & NEUROSCIENCE SELECTED READINGS Applegate, J., & Shapiro, J. (2005). Neurobiology for clinical social work: Theory and practice. NY: W.W. Norton & Company. Arden, John B., & Linford, Lloyd (2009). Brain-based therapy with adults: Evidence-based treatment for everyday practice. Hoboken: John Wiley & Sons, Inc. Badenoch, Bonnie (2008). Being a brain-wise therapist. NY: W.W. Norton & Company. Cameron, N., & McDermott, F. (2007). Social work and the body. Hampshire, UK: Pagrave Macmillan Cozolino, Louis (2010). The neuroscience of psychotherapy: Healing the social brain. Second Edition. NY: W.W. Norton & Company. Damasio, Antonio (1999). The feeling of what happens: Body and emotion in the making of consciousness. San Diego: Harcourt, Inc. Damasio, Antonio (2000). Descarte's error: Emotion, reason and the human brain. NY: Quill. Damasio, Antonio (2003). Looking for Spinoza: Joy, sorrow and the feeling brain. Orlando: Harcourt, Inc. 68 MINDFULNESS MEDITATION & NEUROSCIENCE SELECTED READINGS Goleman, Daniel (2006). Social intelligence: The revolutionary new science of human relationships. NY: Bantam Books. Grawe, Klaus (2007). Neropsychotherapy. NJ: Lawrence Erlbaum Associates, Publishers. Johnson, Harriette C. (2001). Neuroscience in social work practice and education. Journal of Social Work Practice in the Addictions, 1(3), 81-102. LeDoux, Joseph (1996). The emotional brain: The mysterious underpinnings of emotional life. NY: Simon & Shuster Paperbacks. LeDoux, Joseph (2002). Synaptic self: How our brains become who we are. NY: Penguin Books. Saleebey, Dennis (1992). Biology's challenge to Social Work: Embodying the person-in-environment. Social Work, 37(2), 112-118. 69 MINDFULNESS MEDITATION & NEUROSCIENCE SELECTED READINGS Siegel, Daniel J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Second Edition. NY: Guilford Press. Siegel, Daniel J. (2010). The mindful therapist: A clinician’s guide to mindsight and neural integration. NY: W. W. Norton & Company. Siegel, Daniel J. (2010). Mindsight: the new science of personal transformation. New York: Bantam Books. Siegel, Daniel J., & Hartzwell, Mary (2003). Parenting from the inside out: How a deeper selfunderstanding can help you raise children who thrive. NY: Penguin. Siegel, Daniel (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. NY: W.W. Norton & Company. Van der Kolk, Bessel. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. NY: Viking. Wilson, Timothy D. (2002). Strangers to ourselves: Discovering the adaptive unconscious. Cambridge: The Belnap Press of Harvard University Press. 70