Determine the neurophysiology of the stress response, including the roles of the amygdala, hypothalamus, sympathetic and parasympathetic nervous systems, and the effects of cortisol and adrenaline.
Discriminate among acute stress, major life events and chronic stressors, and the longer-term effects of chronic stress on mind and body.
Implement grounding strategies to help clients who experience "freeze" states or dissociative symptoms.
Communicate the concept of mindfulness, how it affects the brain, and how to use mindfulness-based interventions in therapy.
Critique the concept of self-compassion and research on its benefits.
Design practical exercises to increase self-compassion in clients facing stress.
Analyze the importance of perceived control to the impact of stressors and learn how to help clients differentiate controllable and uncontrollable aspects of stressors.
Explore how stress and anxiety narrow cognitive focus and create thinking traps and learn techniques to help clients be more cognitively flexible in the face of stress.
Evaluate the research suggesting that positive emotions can undo the physiological effects of negative emotions.
Investigate how rumination exacerbates the effects of stress and how to help clients curtail ruminative cycles and de-fuse from negative thinking.
Appraise how a growth mindset differs from a fixed mindset and how to help clients adopt a growth mindset and a gritty attitude towards their stressors.
Assess the application of a brain-based, neuroscience approach to treating clinical disorders like GAD and PTSD.
Using Neuroscience in Treatment of Stress and Trauma
Science gives authority, evidence, de-stigmatizes mental health problems
Increased motivation and hope for change
Oversimplification, unrealistic expectations, changing state of science, see self as damaged or different
The Promise of Neuroplasticity
Describe neuroplasticity in everyday language
Therapy is about creating a new, more resilient brain
We are changing beings - don't have to be stuck in rigid views of self
Teach brain to be less reactive to stress and triggers
"Rewiring" as a metaphor for change
Changing "raw," unprocessed memories to organized narratives
The Brain's Stress Response
Historical view - Hans Selye
The brain's stress response "fight, flight, freeze"
The triune brain - reptilian, mammalian, human
The amygdala and the prefrontal cortex
How the amygdala "hijacks" the brain into emergency mode
How the Stress Response is Spread Throughout the Body
Neurotransmitters - Epinephrine, norepinephrine and cortisol
The HPA axis and role of cortisol
The sympathetic and parasympathetic nervous systems
The dorsovagal "freeze" response to unavoidable threat
The Upside and Downside of Stress
Increased motivation and engagement - "flow" state
Can create mental toughness and resilience to future stressors
Inflammatory response to chronic stress
Stress and health risk behaviors (excess alcohol use, smoking, overeating etc)
Stress and cellular aging (telomeres)
Traumas - Effects on the Brain
Cortisol attacks the hippocampus - center of narrative memory
Amygdala response increases in strength
Impaired anterior cingulate cortex (ACC) and prefrontal cortical function
Cortisol halts production of BDNF - fewer new brain cells formed
Link to depression, anxiety disorders, PTSD
Cognitive rigidity and inability to take in new information
Changes in sense of self and dissociation
Long-Term Impact of Adverse Childhood Experiences (ACEs)
The ACE Study (Kaiser and the CDC)
Addictive and unhealthy ways of managing anxiety & negative emotions
Disease, mental health issues, behavioral problems, PTSD
Explaining Neuroscience Concepts to Clients
Use drawings and images
Individualize to the type of difficulty (e.g., disengaged vs reactive - different brain areas)
Redirect vs eliminate
Help client label & recognize when happening (e.g., freeze, flooding, negative thinking, rigidity, impulsivity)
Find coping strategies for each type of brain difficulty
Stress-Proofing the Brain - Overview
Calming the amygdala - Grounding, mindfulness, self-compassion, perceiving control
Moving forward with the prefrontal cortex - Cognitive reappraisal, priming positive mindsets and, growth focus, health psychology tools
Grounding Strategies for Clients with Trauma or Attachment Injuries
Yoga, relaxation, breathing, present-moment focus, soothing with the senses, pets, drawing, gardening, walking
Mental imagery - safe place, boundaries, energetic, times they felt strong/competent
Left-brain strategies - task focus and engagement
Qualities of mindfulness states - open, nonjudgmental, fluid, deliberate,
Observing and accepting inner experience (thoughts, feelings, sensations)
Using the senses to self-regulate
De-fusing from negative thoughts and self-images
How mindfulness changes the brain
Mindfulness practices - breathing, watching thoughts, urge surfing, open awareness
Application to anxiety, depression, addictions, PTSD
Self-kindness, common humanity, focus on unmet needs
Application to depression, anxiety, stress-management, trauma, insecure attachment
Link to Schema Therapy - healthy adult mode
Practices - Metta meditation, soften, soothe and allow, dialogues with inner critic
How stress and anxiety narrow attention, create cognitive rigidity
Depression and negative thinking
PTSD and internalized negative appraisals (helpless, unworthy, unsafe etc.)
Worry and rumination cycles - link to prefrontal cortex and default mode network
Why thought suppression doesn't work
De-catastrophizing and probability estimation
Exposure and tolerating negative thoughts
Using metaphors (monsters on the boat, bouncy ball underwater)
Creating Positive States of Mind to Counter Stress
How our brains are wired to the negative
Positive emotions can promote physiological recovery from anxiety and fear
Reappraising anxiety as excitement
Commitment, control, and challenge; growth mindset
Living Healthy in the Face of Stress
Sleep disturbance - behavioral strategies
Healthy coping strategies - exercise, meditation, yoga
Dealing with emotional eating
Melanie Greenberg, PhD, is a practicing psychologist, author, speaker, and executive coach with more than 20 years of professional experience. She has an active practice in Mill Valley, CA where she sees individuals and couples, teens and adults. Originally from South Africa, Melanie has a passion for psychological growth and healing. She loves to challenge, inspire and motivate. Melanie is the author of The Stress-Proof Brain (New Harbinger, 2017) – an Amazon bestseller in neuropsychology, stress-management, and health. She writes the popular Mindful Self-Express blog for Psychology Today (8 million page views) and has a substantial social media following. Melanie is a former professor in the clinical psychology Doctoral Program at Alliant International University, San Diego. She has delivered talks and workshops to national and international audiences, businesses, nonprofits, and professional organizations, including The American Psychological Association, Wisconsin Psychological Association, Society of Behavioral Medicine, and The Bay Club. She has also published more than 50 research articles and scholarly products. A popular media expert, she has been featured on CNN, Forbes, Inc., Business Insider, BBC radio, ABC News, Yahoo, AOL, and Lifehacker, as well as in Self, Redbook, Women’s Health, Men’s Health, Fitness Magazine and the Huffington Post. She has also been featured on radio shows and numerous podcasts. With almost 50,000 followers, she was named one of the Top Psychologists to follow on Twitter by The British Psychological Society.