Senin, 10 Oktober 2011

How Therapy Heals by Changing the Brain: Mindfulness, Attachment, and Interpersonal Neurobiology



This article explains how mental health and healing can be understood from an attachment and neurological perspectives. Psychotherapy has the potential to change the brain by increasing neural integration, allowing all parts of our brains to function as a whole. This type of work increases one's ability to regulate emotions, maintain a sense of self, to connect and empathize with others, to respond flexibly to manage fear, have a moral conscience and find smisao.Neurološki surface will be addressed, as well as therapy, mindfulness practice, and who have loving relationships can all do impact our neurology, our ability to form healthy attachments, and our overall mental health.

Attachment theory: To understand the healing process (and psychotherapy), it is important to know a little about attachment theory. This theory was developed by John Bowlby in 60 years but has recently gained prominence, mainly because of the exciting developments in the area that shed light on how the item (eg early childhood) experiences influence brain development. Attachment theory explores the critical importance of early experiences with the baby's caregiver to help shape later patterns of relating that include a sense of self (eg, "I received a lot of love, so I must be a million"), the expectations of others (eg, "If I need to express, I will be disappointed / punished "), a strategy for handling relationships (eg," I can not expect consistent care than others, so I'll learn to take care of yourself ").

Children have little choice but to our understanding of reality, and their strategies for dealing with that reality, what they experience at home. Perhaps the most important aspect of learning is what they expect from other human beings. This is due to the fact that social relations are critically important for life. Because people have a much better chance of survival (and reproduction) in the group, we are literally connected to the need for relationships, for our sense of security, for our mental and physical health, and our ability to find meaning. This wiring explains why so much of our sense of well-being depends on our relationship and why come from families who instills negative expectations of others (and subsequent inappropriate strategies) can be so debilitating.

Since the related key to survival, many of the brain devoted to monitoring and participating in social behavior (determining the safety or danger, the expression of heat or threats, etc.). According to Allan Schore, a nationally acclaimed researcher in the right hemisphere is hardly involved in human processes. It is also the side of the brain that develops more actively in the first two years. During this time the brain is extremely plastic, with the nerve pathways to be regulated and strengthened (or not use, atrophying). It is a concept some find surprising May. It would be easy to assume that the brain is pretty much fully structured at birth (such as hands and feet). But, in fact, the experience of working together of genetics to determine how the brain is wired. Because so many right brain was molded during the first two years, this period is particularly critical in terms of learning how to trust and relationships with other people. Reading social cues, having empathy, and even be able to like yourself and others, based on how the brain is wired. Although the wiring is largely determined by how it was related as a child, a corrective experience in adulthood (as therapy) luck can change the wiring of the brain, as well, I'll say more about later.

Attachment and the Brain: Studies on how attachment experiences influence the brain is largely developed by psychiatrist named Daniel Siegel, whose work many therapists, psychologists and teachers have grown interested in the past 50-10 years. Siegel has developed a field of research called interpersonal neurobiology of attachment, which deals with how the brain is wired through past experiences and how new experiences can help rewire the brain. In recent years, interest in this area has rocketed, I believe because of the Siegel article confirms what psychologists always known-that early relationships are important and helps us to understand why they are important from a biological point of view. Although specific knowledge in the brain may not be necessary for therapy or counseling, I found it very useful to orient clients to some general principles that Siegel (and Allan Schore, Steve Porges, among others) found. There is something useful about the design of our behavioral / emotional problems such as gaps in our nervous system. This can reduce the damage (because it shows that our vulnerabilities are not "deliberately") and will strengthen (from understanding the science behind what we experience can help us shift ).

Since the area of interpersonal neurobiology, and other advances in attachment theory are so revolutionary, there is a tremendous amount of excitement about the therapeutic zajednici.Broj approach to therapy, including accelerated Experiential Dynamic Psychotherapy, sensorimotor psychotherapy, Psychobiological Couples therapy, emotionally focused therapy, and systems-oriented therapy, include an attachment to the idea of their techniques.

Let me tell you more about what we are taught Interpersonal Neurobiology. According to Siegel, the brain becomes wired largely based on social stimuli (such as smiles, cooing, being struck or held), which activate specific patterns of neurons. For example, if your baby cries, and then picked it up and soothes the brain is learning how to move from a state of upset at the situation calmly. In other words, the nerve pathways are formed so that different parts of the brain can work together to deal with disturbing emotions. On the other hand, if the baby cries, and ignored or even punished, then the child not only learns an important "reality" (as if there is no point in reaching others, and that emotions lead to frustration, isolation and being overwhelmed) but his or her brain is also left in a prolonged state of chaos or upset, what therapists call emotional dysregulation. Given that "neurons that fire together wire together," he said over the brain remains in some countries that the lack of integration (especially when we are young), the more likely one will return to the States later.

When parents are available, customized, and non-intrusive, children are able to use them for emotional regulation. This kind of support children's brain patterns to healthy independence (where they can care for themselves, but also allow others to care for them when necessary). When parents are inconsistent, the child can learn to keep your loved one to get what she needs, and thus engraining style of relating (or "attachment style") which is very sensitive to cancel (this is called a preoccupied or ambivalent attachment style). On the other hand, the child may feel so neglected that he or she "gives" to others and shut down their need for support to such an extent that it can be difficult to get much support at all in later life (this is called an avoidant or dismissive attachment style ). Although these adjustments may be necessary during childhood, they may be unhappy later on, since they have a secure connection to another can be a uniquely effective way to emotionally regulate.

To summarize, for people who have not had a positive experience to manage their carers, on May be difficult for others to use them effectively when dysregulation occurs. In couples counseling, teaching partners to successfully use each other for control is the key to treatment and can often make the difference between a safe, healing relationships, and insecure, damage to (or distant) one.

Emotional Regulation: Before I go any further, let me say something more about the concept of emotional regulation in relation to the dysregulation, as it is one that is often at the center of therapy. Emotional dysregulation is a word used to describe a situation in which the brain has difficulty in handling the level of emotion. It is very common (in fact, all of us get dysregulated from time to time). A person may be too "low" (failed, desperate, turn off the emotions) or too "high" (flooded, upset, overwhelmed). Building on this idea, described by Seigel emotional resilience as the ability to maintain a balance between the state of chaos and rigidity. Chaos and rigidity are at opposite ends of a continuum in terms of brain states, and has to do with the lack of integration between parts of the brain.

two types of integration are important in the brain - horizontal integration (between right and left hemispheres) and vertical integration (between higher and lower center). If anything is missing, then chaos and rigidity occur. Chaos occurs when the brain centers responsible for emotional responses (middle and lower, and the right brain) fire without modulation of the more soothing and "thinking" (above and left) parts of the brain. This occurs when a person becomes flooded or overwhelmed with emotion. In these states of chaos, the therapist will try to bring the client back into the window of emotional tolerance by helping bring a "higher" brain function back on-line, thereby supporting his / her sense of security, structure and stabilnost.Terapeut presence alone can act as a stabilizing force. Also, because of the language center in the left hemisphere, just naming what he feels may activate the left brain, and thereby help to create order out of chaos (hence the saying "you name it to tame it ").

In contrast, stiffness occurs when the left and more analytical functions of the brain is activated with minimal input from the feeling, intuitive, empathic function of the brain. People who tend toward rigidity is often described as too "in your head." They are able to rationally analyze a problem, but may have difficulty knowing what they feel or want, or the lack of a gut feeling for what is right for them. In this case, a psychologist active support to help customers access to the feelings they May have to ignore or avoid.

Most people tend to either rigidity or chaos. It is also common to move between both countries, perhaps getting overwhelmed when the emotion occurs (chaos) to the point that closes and becomes a defense (stiffness). Obviously, the experience of chaos is very uncomfortable and inhibit daily functioning. It's hard to think straight, for example, when we are very worried and angry. For people who have problems with chaos, it's as if emotions are "abducted" them, taking them somewhere where they are uncomfortable and a bit of control. May these people get stuck in feeling that they do not know how the process to completion and that, therefore, feel disenfranchised. Stiffness, in turn, means a loss to follow one's emotions at all or have little sense of one's true self. While stiffness has the advantage off the negative feelings to the exclusion of the lack of positive feelings as well, including a sense of connection and intimacy. I would describe these two opposites as two sides of same coin, because the people who cut off their emotions usually do so because they fear being overwhelmed by them.

In order for an individual to have more emotional resilience and flexibility, the new nerve connections to be forged in the brain so soothing and organizing functions can come on-line, when things are too chaotic and enriching functions can occur when the on-line things are too rigid. This is integration.
How therapy helps: So how does therapy help with these issues? The therapy is (in part) by providing an individual experience is the first conscious emotions (which slows down and circumvent the defense), then moving through the emotions, without being too dysregulated him. I hope that the therapists' presence, monitoring processes, and ability to remain regulated in the face of strong feelings can help clients pace, soil, and incorporate their experience. Think about how much learning can take place in those moments! First, the brain is learning how to "ride the wave" of emotions. To use this metaphor, when someone learns to surf, the more he or she practices, it becomes more engrained in the body, so that the body knows how to stay on top of a wave without thinking. This is because the new neural connections are formed in his brain. Similarly, the body / brain has to learn how to navigate through the emotions in a smooth, controlled as it is not too intensive (chaotic), without being too flat (rigid) or. In this metaphor stiffness may not look like getting into the water in the first place, chaos will take to the waves crash on top of you.

Second, the therapeutic process should help the brain learn to be safe to share themselves with one another, and that it can be useful, even deeply satisfying to do so. On this more subjective level, many of my clients have described the experience of their real feelings, even painful ones, as beautiful. They say it gives a sense of connection with me-other people (which are predisposed to enjoy), and a deep sense of connection with them. This experience not only at the level of intellectual insight (though often insights come from this process), it is the experience at the end truly be one with yourself. Just this week I have a client tearfully tell me at the end of the session that she felt just experienced a "home-coming." She did this attuning and listening to what is "inside ."

"from within" might sound like a strange place, but there are ways to get a little more concrete. One way to do this is to orient ourselves towards a sensation in one tijelu.Tijelo, after all, is where the "feel" our emotions, just as the stomach pain and many other biological processes. The slowdown in the check-in with our physical experience is a concrete way to begin getting the awareness of our emotions. Any way we can tune into ourselves, in fact, can help in this process. We listen to the nature of our thoughts, take note of our energy levels and where the tension is kept, to identify pulses, notice our breathing and heart rate, pay attention to the feeling of emotions, there are many ways to tune into one myself. Paying attention to the body is a great place to start, as it enters the body comes to mind first right and then left. This "over" movement encourages both vertical and horizontal integration.

Making Implicit Explicit:. "Analyze" The body also provides information that is difficult I have heard many clients say they are looking for advice, because the analysis is not very helpful. On the other hand, simply paying attention to yourself can be very fruitful and give us a more honest picture. Specifically, the left brain is large and confabulating (comes with fictitious answers, like "I snapped at you because XYZ ..."), while the body is, on the other hand, does not lie. When we listen to the body (or the right brain), we have the realization that feel "real" as a gut feeling or do not know. These are usually more accurate and helpful. Allan Schore believes the information in the possession of the right hemisphere can be compared with what is traditionally called the unconscious. As therapists have always believed, that this kind of implicit information explicit is very important. I like to think of the right brain information as "raw data" about our experience that the left brain can then be taken and analyzed. Without it, raw data, the left brain is likely to create, but not necessarily accurate, explanation.

Implicit Memory: Following up on this idea, many of my clients have discovered the concept of implicit memory is very useful in understanding their experience. Implicit memory occurs when we have some memories from the past without a sense of memory (in other words, we have no idea what we have memory). The most extreme version of the flash-back.Flash-back occurs when the brain remembers the traumatic events without people knowing that it is only sjećanje.Osoba having a flash-back is not aware that he or she has some memories of the past and she feels as if the past experience of what is happening again in the present. This is because the brain processes information differently during particularly stressful (or traumatic) moments. Specifically, an overwhelming experience not to be encoded in the brain that is normally responsible for memory, so when he recalled later, we know we have a memory.

A similar process can happen to people who have stressful experiences during childhood. When these experiences are remembered implicitly, people can once again experience a certain feeling that during childhood, not realizing that sense refers to the past. Instead, they believe that they feel in relation to the present. It can be very confusing, leading people (and their loved ones) to wonder at the severity of their reactions. For example, suppose a woman has a history of being humiliated by her father. When her husband gives her feedback, it is quite possible for the memory that humiliated as a child to run on the implicit level. If so, then suddenly re-experience the painful feelings had in childhood, and believe that in response to her husband's behavior. When several members are aware of each other implicit memory, they can easily understand and deal with, their partner's emotional reaction is surprising. This is somewhat addressed in couples counseling.

Making sense of implicit memory is another important reason for listening to body / right-brain. To summarize, be able to know yourself and your emotional world, without being overwhelmed with all the feelings that live there, provides a sense of vitality, wealth, and self-understanding. Being present with the "Realness" of this experience, while being able to contain and make sense of it, is what makes the consultation process empowering and healing, not to mention insight into the production. Being present is the key to integration, because it enables all aspects of themselves that appear suddenly.

Mindfulness: If "be present" sounds a little "Woo-Woo" or vague, let me explain further by introducing the concept of mindfulness. Mindfulness is a process of observation of one's experience, at any time and without a verdict. This means only spot I notice no intention to change it, or criticize yourself for it. Yes, it is similar to the idea of ​​meditation, and is not a new concept. What is new is the understanding of how to practice mindfulness changes in the brain, the frontal lobe activity increases, cell growth in areas such as the hippocampus, insula, and strengthening (which facilitates empathy). Although therapists can not measure the physical changes during the consultation, the consultants can see the customers will be able to find peace and strength to face difficult emotions.

This is obtained by force, because different parts of the brain of clients learning to work together in an integrated, harmonious manner. When the therapist helps clients to be mindful of their feelings, they provides the emotional centers of the brain that are stimulated, while at the same time using other areas as well.
When we are able to "look" of our feelings, we are learning to keep more than one function at a time. Sometimes it can be a little leap for people to learn this on their own-it can be difficult to feel the fullness of your feelings without external podrške.Psihologa or presence of another person can give it features. In other words, the other person's brain works with our security and to help communicate with the regulations. Therefore, when we can get our higher brain functions online, we can use other people as a crutch or a guide. When the children to their parents in this way, they not only get a temporary soothing, but their brain development have become more integrated.

For example, suppose that the six-year-old boy was upset because he got teased in school. He comes to her mother in tears, unable to cope with their feelings towards you. His mother takes him on her lap, soothing him through their proximity, vocal tone, warmth and touch. His brain has a chance to practice moving from one state dysregulation of regulation (as we know, the practice of growing nerve connections). In addition, the mother whispered to him: "I know, so it is very embarrassing to be teased. It really hurts. It is natural to cry about it, and maybe that will help you feel better." Her words trigger more thinking, understanding the front part of his brain, not the way to turn off their feelings, but in a way that allows him to think and feel the same vrijeme.Više is this kind of support, the less frightening emotions will be felt (in fact they may be associated with a very positive experience of love and relationships!), and less likely to be confused and agitated by emotions like an adult (or should be excluded entirely ).

For example, suppose that the six-year-old boy was upset because he got teased in school. He comes to her mother in tears, unable to cope with their feelings towards you. His mother takes him on her lap, soothing him through their proximity, vocal tone, warmth and touch. His brain has a chance to practice moving from one state dysregulation of regulation (as we know, the practice of growing nerve connections). In addition, the mother whispered to him: "I know, so it is very embarrassing to be teased. It really hurts. It is natural to cry about it, and maybe that will help you feel better." Her words trigger more thinking, understanding the front part of his brain, not the way to turn off their feelings, but in a way that allows him to think and feel the same vrijeme.Više is this kind of support, the less frightening emotions will be felt (in fact they may be associated with a very positive experience of love and relationships!), and less likely to be confused and agitated by emotions like an adult (or should be excluded entirely ).

Markers of change: Regarding the discussion of change, it seems that two particularly strong markers of change. One indicator is the ability to tell a coherent and meaningful story about his life and how it develops in a person is today. For people who have had to defend themselves from their experience, they often lack access to information, right-brain / memory / processing to make his story a sense of "Realness" and emotional connection. I am amazed at how often people come into my office and say that I do not remember my childhood much at all. When the psychologist helps you build a fuller understanding of his life, it requires participation from many parts of the brain, which, again, integration is encouraged.

another indicator of growth is the ability to be able to note, as described above. To say something more, being careful is similar to being a good parent yourself. It is reassuring to know that paid attention to, without trial, and the children (who are often turned away when someone is there for them) and adults. In many ways, mindfulness is about learning to be positive, caring attitude towards yourself, where are we ready to "show" and notice what happens to us. I often try to take this a step further with its customers brings in attitude, not only non-judgment, but at the end of compassion. At Deep Eddy Psychotherapy, we call it extremely healing relationship with yourself and your experience "Advanced mindfulness." I have many customers who enjoy using the images to further this process, as I see fear as a 4-year-old version of himself which can then predict the maintenance and comforting.

For those of you who are interested in more in-depth understanding of mindfulness and the brain, I highly recommend the book Mindsight Seigel. Obviously this is a skill that can be practiced in therapy, but attention also can be practiced on its own. I often recommend that my clients have daily care practices, even if only a few minutes before going to bed. This process involves simply paying attention to what we observed in the free trial. Doing a body scan (take a note slowly through the body to see how each part feels) can be very useful. Researchers have found that mindfulness practitioners have a thicker middle prefrontal cortex, an area that is key to the "governing body, attuning others, balancing the emotions, to be flexible in our responses, soothing colors and creating empathy, insight, moral awareness, and intuition" (p. 9 in the book Mindsight Seigel). In fact, engaging in 30 minutes of meditation practice for only 8 weeks showed that changes in the brain.

The role of the therapist: For the reasons stated above, consultation with emotionally focused therapist is less content-driven (or events described receiving advice), and more on monitoring their own moment to moment experience in a room with a counselor. I slanted to a counselor, because often that someone is actively coordinate and monitor our state and feelings is a new experience and one that is crucial for healing. This type of interaction can connect the experience of emotion with the experience of safety and connection (so that they become connected in the brain). Also the way templates that relate to yourself and your feelings, which is marked curiosity and compassion. When others treat us care (or, using an attachment to the language, the compliance), helps us to relate in positive ways as well. (Back, as we know too painful, it can be accurately ...).

group therapy: I recommend group therapy in addition to individual performance for almost all of my clients (or sometimes as an alternative to individual work for people who are looking for a lower cost form of treatment). Given the information presented above, the reasons for group therapy is as effective but can be clear. As I described, human relationships are such an impressive part of our lives, cause very functioning of our brains! Group therapy nourishes our right-brain, giving us a place to practice skills such as resonating with others, relate to a deeper way, to use a word attachment, co-regulated (when two minds come together to make the emotional experience more manageable and less alone). The group is also a place for understanding our reactions to others and our relational patterns (defense, the roles we are in, an imbalance in the giving or receiving, etc.). Spending 90 minutes every week with a group of people who are interested in expressing their true feelings and explore what the reactions of the notice at the moment is enriching and transforming, that might be considered a kind of attention, but in this case, practicing in a group where enriched people's support.

Couples counseling: for individuals who are part of a committed relationship, couples counseling can not only help heal the relationship, but individuals in the relationship, as well. If you are thinking about the beginning of the consultation, I'd consider starting with couples therapy, even in individual therapy (assuming that one partner will be willing to engage in the process with you). I recommend it because the only people with their therapists usually for one hour a week while they are with their partners for many hours a day. Therefore I see no reason for couples not to get involved in the therapeutic journey together (if available). In this case, the therapist can coach each partner learning to provide partners with a positive, safe experience regarding the condition trouble.

For more information on psychotherapy, my practice, or yourself, please visit my website.





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