Brain Talk: Integrated therapy that includes a discussion about the brain with the client Part 4 of 8

This seminar will include suggestions on how to communicate to clients about the brain. Therapists can engage clients by discussing the concept of neuroplasticity, and present them with evidence-based techniques with which they can “rewire” their brains. Specifically, therapists can focus on how anxiety and/or depression are processed by the brain and what the client needs to do to become less anxious and/or depressed. Clients are more responsive when they hear less theoretical jargon and more concrete brain-based explanations about their problems. Since people who are suffering from anxiety and/or depression are so overwhelmed by their symptoms, they find it hard to remember what to do that would make them feel better. Therefore, when discussing each disorder it can be useful to describe a mnemonic that can be used with clients so that they can remember the important behaviours that need to be made to deal with their anxiety or depressive symptoms. The brain serves as the common denominator for all approaches and can be used to explain particular approaches to clients.

Part 4 of 8

The Brain-Based Common Denominator

• New discoveries in neuroscience that inform psychotherapy
• Neuroplasticity – the need for a moderate degree of activation
• Neurogenesis – motivation to exercise and learn
• Affect asymmetry – establishing new set points
• The amygdala – fast and slow tracks
• Default mode network – making daydreaming useful

The Social Brain-Based Therapy

• Polyvagal Theory – social engagement system
• Mirror neurons and spindle cells – increasing empathy
  and emotional intuition
• Attachment and temperament – earning security
• Facial expressions – enhancing mood
• Attachment and transference – earning security
• Outcome management – monitoring the relationship

Maintaining Healthy Brains: Planting SEEDS

• Social support – activating and maintaining the social brain networks
• Exercise – balancing moods, boosting cognition and stimulating neurogenesis
• Education – broadening cognitive reserve and expanding adaptability
• Diet – providing the building blocks to a healthy brain
• Sleep – maintaining sleeping hygiene to keep moods balanced and cognition clear

REST from Generalised Anxiety

• Parasympathetic activation – somatic exercises
• Cognitive reframing and thinking reasonably
• Flooding the worry circuit – scheduled worrying
• GAD – The Orbital Frontal Cortex and exposure to ambiguity
• Client education: the mnemonic REST

BEAT Panic

• Desensitising the amygdala – learning to avoid avoidance
• Exposure – learning how habituation deactivates the amygdala
• Interceptive exposure exercises – teaching clients to embrace their body sensations
• Speeding up the slow track – getting the left pre-frontal cortex involved
• Client education: the mnemonic BEAT

SAFE from Posttraumatic Stress

• Phase 1 – Stabilisation
• Phase 2 – Integration
• Phase 3 – Posttraumatic Growth
• Client education: the mnemonic SAFE

Healthy ORDER

• Engaging attention – helping clients shift out of automatic behaviours
• Developing more adaptive behaviours
• Exposure – to habituate to discomfort
• Response prevention – from urges to engage in compulsive behaviours
• Client education: the mnemonic ORDER

TEAM for Depression

• Restoring physiology – sleep hygiene techniques
• The Effort-Driven Reward Circuit – Behaviour activation
• Hippocampus – Providing realistic context to break out of mood
  congruent thinking
• Kindling the left PFC – Countering negativistic thinking with inquiry and
  details, affective labelling and approach behaviours
• Mindfulness – quieting ruminations and neutralising monotony