Full Course Description


Psychotherapy and the Mind-Body Connection: Integrating Principles of Psychoneuroimmunology, Epigenetics, Nutrition and Neurobiology in the Treatment of Trauma, Anxiety and Depression

Program Information

Objectives

1.  Evaluate the role of diet and health related behaviors on genetic expression and neurological health.

 

2.  Explain the relationship between adverse childhood experiences on health, behavior and mental disorders.

 

3.  Structure lifestyle interventions that improve the expression of health-based psychiatric symptoms.

 

4.  Differentiate between implicit and explicit memory and their roles in therapy.

 

5.  Contrast the fast and slow tracks to the amygdala and the role they play in anxiety disorders and therapy for individuals with anxiety disorders.

 

6.  Apply evidence-based health and behavioral approaches to promote neuroplasticity and adaptive brain growth.

 

7.  Articulate the role that attachment plays in the development of affect regulation and mood disorders.

 

8.  Individualize therapeutic interventions to specifically target brain functions affected by adverse experiences and stress.

 

9.  Contrast cognitive-behavioral and metacognitive models of anxiety treatment.

 

10.  Effectively communicate a comprehensive approach to treatment to individuals with OCD.

 

11.  Evaluate the role of medications, substances and physical status in the experience of depression.

 

12. Explain how mindfulness meditation affects the brain and is used in the treatment of anxiety

disorders and depression.

Outline

Session 1 - The integrative approach—no more need for the “schools” of psychotherapy

               

                Necessary elements of a comprehensive client view

               

                Historical perspectives on therapy – search for common factors

 

Psychotherapy and the brain – Brain-Based Psychotherapy

               

                Mind/Brain causality – interaction of multidimensional feedback loops

               

                Results from the ACE study – health, behavioral and psychic impacts of adverse experiences

 

Mind-Brain-Gene feedback loops

 

                Epigenetics in gene expression – effect of nurturance on stress tolerance

               

                Early experience – neurological responses and neurochemical risk factors

               

                Cell-DNA interactions – highlighters, erasers and decoders

 

                Intergenerational Transmission – passing on the effects of trauma

 

Gene expression - cell aging and telomeres

               

                Factors that impair DNA and cells – interventions to minimize telomere shrinkage

 

Components of the immune system

 

                Pro-inflammatory Cytokines - relation to emotional symptoms and physical disease

 

                Short term stress can suppress the immune system

 

                The brain controls the stress pathways – involved neurological systems

               

                Communication in the immune system happens via chemicals

 

                Role of chronic brain inflammation

 

Obesity pandemic – relationship to early death and psychological vulnerability

               

                Obesity, chronic adipose tissue inflammation and diabetes

 

                Diabetes, stress and psychological disorders

               

                Diet, inflammation and pre-diabetes

                               

                Cardio-metabolic syndrome – cognitive fog and mood disorders

 

                Depression has a relationship to chronic inflammation - “sickness behavior”

 

Hypocortisol vs Hypercortisol activity – maintaining appropriate balance

               

                Immune dysregulation and hopelessness

 

                Inflammation and dementia

 

                Peripheral nerve involvement

 

Enteric nervous system – the “gut brain”

 

                Microbiome – good and bad microflora

 

                Lifetime psychiatric disorders associated with irritable bowel syndrome

               

                “Leaky gut” syndrome – consequences of stress and inflammation

 

                Dysbiosis and microbial diversity – the importance of balance

 

Session 2 - Self-regulatory interventions – self-care behaviors “SEEDS”

 

Movement is an evolutionary imperative – role of beta-endorphin

 

                Exercise increases neurotransmitters, reduces inflammation, improves mood and sleep

 

                Cardiovascular exercise and cortical plasticity – improving cognitive clarity

 

                Exercise induced myokines and anti-inflammatory effects

 

Working and long-term memory - implications for psychotherapy engagement

 

                Implicit vs explicit long-term memory processes

 

                Role of amygdala and hippocampus in memory function

 

                Case example – H.M. and removal of hippocampus

 

Threat appraisal – amygdala vs cortical circuits

 

                The dynamics of fear- negative memories and narrowed focus of attention

 

                Positive emotions and expanded focus of attention

 

                Client education - memory improvement

 

Diet and cognitive function

 

                Perils of the Western diet – impact on dopamine receptors and experience of pleasure

 

                Priming appetite and obesity

 

                Cognitive effects of B vitamins deficiency and elevated glycemic load

 

                Effects of Omega-3 and Omega-6 Fatty acids

 

                Glycation and impact of excess glucose and fructose in diet

 

                Trans-fatty acids and alteration of neurotransmitter synthesis

 

                Protecting the brain from pre-diabetes and Metabolic Syndrome

 

                Client education essentials

 

Sleep and circadian rhythms

 

                Synchronizing circadian rhythms and sleep patterns

               

                Negative effects of computer use and light spectrum exposure

 

                Medical conditions contributing to sleep disruption

               

                Normal and pathologic sleep architectures

 

                Slow wave sleep deprivation

 

                Sleep changes over the life cycle

 

                Brain clearing – the “glymphatic” system

 

                Sleep deprivation impairs memory – sleep hygiene interventions

 

Session 3 - Habit and motivation - brain reward pathways

 

Role of dopamine, nucleus accumbens and ventral tegmental area in habit formation

 

                Drugs associated with neurotransmitters

 

Effects of acute alcohol on neural circuits – downregulation of neurotransmitters

 

                Brain recovery from alcoholism – persisting cognitive dysfunction

 

                Long term effect of alcohol – brain atrophy, cognitive impairments

 

                Client education - alcohol, mood and sleep

 

Dopamine firing patterns – response to expected and unexpected rewards

 

                Establishment of habits – wanting vs liking

 

                The “white knuckle” paradox – counterproductive nature of “just say no” approach

 

                The Middle Path – dopamine recycling

 

Neuroplasticity – increases in synaptic efficiency and receptor density

 

                Growth of dendrite spines and synapses

 

                Client education – “rewiring” the brain

 

                Habits as entrenched neural pathways

 

                Examples of neuroplasticity – growth in hippocampus and grey matter

 

                Bidirectional mind/brain causality

 

Yerkes Dodson arousal curve – problematic levels of arousal

 

                Client education – acting outside of comfort zone for increased neuroplasticity

 

Brain Derived Neurotropic Factor – impact on neural growth

 

                Factors that increase and decrease neurogenesis

 

                Client education – relationship of diet and exercise to brain health

 

                Iceland Project – results from international research into health behaviors in youth

 

Session 4 – The social self

 

The role of social engagement in the development of self

 

                Hunter-gatherer adaptation boosted the social brain

 

                Regulatory networks of the social brain

 

                Developmental programming of stress responses

 

                The effects of social medicine

 

Cell aging: shrinking telomeres

 

The cost of loneliness – vulnerability to depression and cognitive impairments

 

                Effects of deprived social brain networks – Romanian orphanage research results

 

Child abuse and neuropathology

 

                Effects of maternal separation

 

                Amygdala activation:  expression in adults vs children

 

                Gender differences

 

                Intergenerational transmission of depression – facilitating caregiver self-care

 

                “Good-enough” parenting and frustration tolerance

 

The neuroscience of attachment – balancing the branches of the autonomic nervous system

 

                Longitudinal effects of insecure attachment – alienation leading to depression and helplessness

 

                Client education – rebuilding the stress thermostat

 

Correspondence between child and adult attachment categories

 

Epigenetics and neuroscience of early experience

 

                Role of oxytocin and the Vagus nerve system

 

                Regulatory actions of cingulate cortex, fusiform gyrus

 

Neural structures associated with social engagement

 

                Insula and empathy – response to touch

 

                Mirror neurons – anticipation of goal directed behavior

 

                Contralateral facial muscles and nerves – D-smiles and feedforward expressions

 

                Effects of smiling and humor – reduction of cardiovascular arousal, improvement of mood

 

Cultural framing – race and ethnicity

 

Maximizing the placebo effect to facilitate positive outcomes

 

Session 5 – Self organization

 

Capacity of complex adaptive systems to achieve higher levels of organization

 

                Mind as a product of interactive systems – continuity and change

 

The Mind’s operating networks – salience, default mode, central executive

 

                Balancing the mental networks – interplay and coordination

 

                Salience network – physiological feedback, desire and emotion

 

                Vagus nerve system – heart rate variability  and modulation of sympathetic arousal

 

                Default mode network – reflection vs rumination

 

                Central executive network – working memory and planning

 

                                Dorsolateral prefrontal cortex – development and function

 

                                Effects of underdevelopment and underactivity in the executive network

 

Mental networks and long term memory systems – integrating explicit and implicit memory systems

 

Affect asymmetry – hemispheric differentiation and balance, associated pathology

               

                Client education – focus on incremental change

 

                Hemispheric differences related to neurotransmitters

 

Placebo effect – impact of positive expectations

 

Allostasis and allostatic load – role in anxiety

 

                Medical and drug related factors that mimic anxiety

 

                Stress - bottom up and top down approaches

 

                Client education – developing durability

 

Sympathetic autonomic nervous and neuroendocrine systems – stress responses

 

                Cytokines and inflammation regulation

 

                Hypocortisol vs hypercortisol activity

 

                Suicidality and anxiety disorders – physiology of generalized anxiety 

 

                Balancing the autonomic nervous system – breathing and overbreathing

 

Activating the parasympathetic nervous system

 

                Case example Jane – breathing and anxiety

 

The worry loop – worry as cognitive avoidance

 

                CBT vs metacognitive models of anxiety treatment

 

                Client education – accepting uncertainty

 

                REAL acronym for anxiety accommodation – Relaxation, Exposure, Acceptance, Labeling

 

Neurodynamics of anxiety

 

                Fast and slow tracks to the amygdala – maintaining functional allostasis

 

                Interventions for automatic thoughts, assumptions and core beliefs

 

                Shifting perspective to speed up the slow track

 

                Avoidance – oversensitizing the amygdala

 

Complex exposure techniques – duration and role of neurotransmitters

 

                Critical aspects of exposure therapy

 

Exercise and anxiety

 

                Client education – accurate somatic interpretation and tolerance of sensations

 

                Interceptive feedback loop – exposure and acceptance

 

Body based therapy and Panic Disorder

 

                BEAT panic – Body, Exposure, Amygdala and Thinking

 

Session 6 – Brain Based Therapy for OCD

 

Brain structures and neurochemistry involved with OCD

 

                The habit brain and OCD – cues and behavioral routines

 

                Orbital prefrontal cortex flooded with nuisance information

 

                OCD as failure of top down control

 

                Pulling out of the OCD circuit – strengthened pathways and improved gating

 

                Client education - ORDER acronym

 

                                Observation - disrupts habitual, automatic behaviors

 

                                Remind – reframing thoughts as from the disorder rather than actual threat

 

                                Doing – establish new behaviors

 

                                Exposure – developing habituation

 

                                Response prevention – strengthening the inhibitory circuits

 

                Case example Penelope – modulating cleanliness obsessions

 

Post-traumatic Stress Disorder

 

                The spectrum of trauma – chronic, severe, inescapable

 

                Worldwide incidence of PTSD

 

                Risk factors for PTSD

 

                Sequential development of PTSD symptoms

 

                Phylogenetic responses to stress – neurodynamic aspects of PTSD

 

                Most common acute post-traumatic stress responses

 

                Multidimensional nature of neuropsychological disorders

 

                Common comorbidity of PTSD and Depression

 

                Non-combat trauma associated with PTSD

 

Lifetime prevalence of common psychological disorders

 

Trauma responses are autonomically driven – hippocampal atrophy

 

                Client education – restoring memory function, understanding necessity of social engagement

 

                Neurochemical vulnerability and disordered fear regulation in PTSD

 

                Prevalence of trauma and probability of PTSD - role of avoidance in chronic PTSD

 

Suicidality and PTSD – risk and prevalence

 

Role of implicit memory in trauma – disrupted integration with other memory systems

 

PTSD treatment outcome research results – limitations of current approaches, future directions

 

                Primacy of exposure and CPT approaches – addressing impaired information processing

 

Signs of implicit trauma memories – physiological and mood changes

 

                Dual processing theory – integrating implicit and explicit memories

 

                Client education – explaining exposure, step by step structure of integration

 

Converting traumatic memories into meaning

 

Explicit and implicit memory integration

 

Continuum of detachment – absorption, dissociation, catatonia

 

Affective regulation of conditioned emotional response – skills and actions

 

                Implementing exposure and counterconditioning – start low, go slow

 

                Client education – purpose of delay and affective tolerance

 

                Activation of conditioned emotional responses and dissociative experiences

 

“Identity training” from dissociation – developing continuity and coherence

 

Goals of PTSD treatment – rebuilding feedback loops

 

Orienting response, REM and memory – common denominators in trauma therapies

 

                Orienting and recoding – novel experience facilitates integration of memory systems

 

                Shifts in attention and asymmetry – tapping techniques

 

Brain Based Therapy and PTSD – first aid, memory integration and posttraumatic growth

 

                SAFE acronym – Stabilization, Acceptance of events, Future hope, Exposure to triggers

 

Session 7 – Depression

 

Conceptualization of depression within Mind-Brain feedback loops

 

Illness and depression – multiple vulnerabilities and interactions

 

                Role of medications, drugs and alcohol

 

                Biologically plausible mechanisms linking depression with chronic heart disease

 

Combining bottom up and top down interventions – Antidepressants vs cognitive behavioral approaches

 

Pro-inflammatory cytokines – relationship with stress and “sickness behavior”

 

                Damage to the anterior cingulate and amygdala and exacerbation of depression and anxiety

 

                Symptoms of sickness behavior

 

Bidirectional depression systems – disruption of mood, cognition, motor deficits and circadian rhythm

 

Gender differences in depression – expression of symptoms, suicidality

 

                Assessment of risk factors

 

Stress induced depression – effects on neurotransmitters and blood flow

 

Re-balancing hemispheric asymmetry

 

                Client education - effort-driven reward circuitry and behavioral activation

 

Impaired hippocampus and over-generalizing – black and white perceptions

 

Exercise and depression – one of the most effective interventions for depression

 

Dysregulated mental networks in depression

 

                Client education – dealing with rumination, accepting negative thoughts

 

Mindfulness and depression – cultivation of awareness and novelty

 

                Meta-awareness – decentering and intentionality

 

Therapy:  Mind-brain-gene feedback loops – upregulation of positive engagements

 

                Client education - TEAM acronym, Thinking, Effort, Accepting, Mindfulness

 

                Research on meditation – brain changes related to practice of mindfulness

 

                Seven principles common to prayer, meditation, relaxation and hypnosis

 

Balancing the mental operating networks – activity and synchronization

 

                Sustaining positive habits

 

Transcendent awareness – compassion, acceptance, contemplation

Copyright : 05/16/2019