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


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.


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

Target Audience

Addiction Counselors, Case Managers, Counselors, Marriage & Family Therapists, Nurses, Occupational Therapists & Occupational Therapy Assistants, and other Mental Health Professionals

Copyright : 05/16/2019