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photo courtesy of oddsock via flickr
Need more incentive to meditate? A recent study headed by Sara Lazar and colleagues at Massachusetts General Hospital documented measurable changes in brain regions associated with memory, empathy, and stress after just 8 weeks of daily meditation practice.
More specifically, the MR images showed increased grey-matter density in the hippocampus, known to be important for learning and memory, and decreased grey-matter density in the amygdala, known for its role in fear conditioning and stress. This has strong implications for utilizing mindfulness meditation in treating trauma, as people with PTSD have been shown to have reduced volume of the hippocampus and larger volume in the amygdala area of their brains, making them more prone to anxiety and memory problems. Could a trauma survivor reverse this through regular practice of mindfulness meditation?
In this study, the participants demonstrated brain changes after only 8 weeks of attending a weekly mindfulness meditation class and practicing meditation at home for an average of 27 minutes a day. Lazar and others had published previous studies that demonstrated experienced meditators appeared to have thicker areas of the middle pre-frontal cortex, an area associated with empathy, emotional regulation, and attunement to others. Yet those studies could not prove that these differences were actually produced by meditation. In contrast, the participants in this study had no prior meditation practice and therefore the researchers were able to surmise the measurable structural brain changes were associated with daily practice of meditation. Moreover, this study included a control group that did not meditate and did not show any changes in the study’s pre and post tests.
In my opinion, this study provides further evidence that integrating mindfulness practices into treatment for anxiety, PTSD, and other trauma related problems is a good idea. Traditionally, research has indicated practicing meditation at least 20 minutes per day produces measurable benefits within 2-3 months. To give people even more incentive, I am offering a free 20 minute Mindful Relaxation audio download on my website, get it by clicking here.
To read the full article, refer to: Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 2011; 191 (1): 36; authors: Britta K. Hölzel, James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard, Sara W. Lazar.
Watch this witty and poignant talk by Brené Brown, a University of Houston professor who studies human connection. She found those who are happiest in relationships are those who are willing to feel vulnerable and admit that they are imperfect.
Thanks to my friend Linda Graham, LPC for sharing this video.
Could we have the potential to “erase” the fear from a traumatic memory soon? Would this relieve PTSD, or cause more problems?
Last month, Science Express published research done by Dr. Richard Huganir and colleagues at Johns Hopkins University suggesting we may be able to manipulate fear-based memories. Laboratory rats were conditioned to fear a tone that was paired with an electric shock. The scientists found calcium permeable proteins, labeled AMPARS, formed in the amygdala for a day or two in the brains of the mice after the shock. The scientists administered a drug to some of the mice to keep their brain flooded with AMPARS longer than 48 hours. These mice retained fearful responses long after the shock, while the mice without the drug gradually appeared to forget the tone had been associated with a shock. The scientists believe this will lead them to develop drugs to manipulate AMPARS to reduce fear-conditioned responses.
However, many folks have voiced ethical concerns, worried this research suggests that scientists are attempting to erase memories. For example, Katie Farinholt, executive director of NAMI in Maryland and Paul Root Wolpe, director of the Center for Ethics at Emory University, opined that “erasing” an aspect of a memory could significantly alter a person’s personality and history. Yet Dr. Huganir clarified that blocking AMPAR’s just eliminates the strong emotions attached to a memory. The process won’t erase the memory entirely.
But, I suspect PTSD and developmental trauma disorders are more than a set of fear-conditioned memories. All sorts of learning takes place when we experience something terrifying or overwhelming. Say you were bitten by a chihuahua as a kid and had avoided them for years until you had this drug administered. Now you may no longer fear chihuahuas, but you still don’t trust your mother who let the darn thing bite you. Yet, now you don’t remember why you don’t trust your mother.
I don’t know if it would work that way, I’m just thinking we can’t control all the neural circuits that get activated around a traumatic memory. Apparently Dr. Huganir believes this too. He sees this research and any potential drug development as an adjunct to trauma therapy, not a replacement. After all, Dr. Huganir notes many behavior and trauma therapies are attempting to do the same thing he is doing. Manipulate memories. Decondition fear responses. Clear negative associations. What’s the difference?
I do appreciate Dr. Huganir’s work. He seems to be very level-headed about what he is doing and is not promising miracles. Honestly, the media seems to be jumping to more conclusions about the potential of this research than Huganir and his colleagues.
What are your thoughts? Do you think there are advantages to having drugs that can manipulate proteins involved in fear-based memories? What concerns you about it? As always, I would love to hear your thoughts!
Scan your brain for signs of PTSD
New technology is allowing us to better understand traumatic memory and flashback phenomena from a neuroscience perspective. In a recent study Minnesota researchers observed that patients with PTSD consistently show heightened activity on the right side of their brain, specifically in the temporal lobe area.
PTSD patients demonstrated this heightened activity performing a simple, objective task. None of the participants were asked to recall traumatic material during the study.
Previous studies have suggested the right hemisphere is involved in flashbacks. In the 1960′s Penfield found that applying electrical stimulation to the temporal lobe in the right hemisphere caused people to re-live and re-enact past experiences. Similarly, this study showed hyperactive communication between the right temporal cortex, parietal and/or parieto-occipital in the brains of patients with PTSD. Yet the heightened activity was there without any additional stimulation.
To measure brain activity, participants wore an MEG helmet while concentrating on a spot 65 centimeters in front of them for 60 seconds. The study included 80 people diagnosed with PTSD, 18 people reporting remission from PTSD, and 284 people without PTSD. Interestingly, the patients reporting remission of PTSD still had heightened activity in the right hemisphere, even though it was less intense than those reporting current PTSD.
The researchers believe this suggests PTSD is not just a disorder of an overactive neural fear circuit. Witnessing this heightened activity on the right side of the brain also supports theories that PTSD is a disorder of memory. In other words, the heightened activity suggests memories are still being represented as purely sensation based, and have not been fully integrated with contextual memory.
From a Rapid Resolution Therapy standpoint, this research may lend support to the concept of the traumatic event leaving an “impression.” We can think of the “impression” as the sensation aspects of the memory still held in the right hemisphere. Our goal with RRT is to integrate the data into the left hemisphere and give the memories some context. This is accomplished through the process of retelling the trauma story while staying emotionally present.
The research study cited in this post was conducted by the Minneapolis Veterans Affairs Medical Center and the University of Minnesota. The research was just published in the October issue of the Journal of Neuroengineering.
If you are a mental health professional and still have not viewed the RRT online class, you can still get access to it. Click here to send me your contact information and I will send you the link and the password for the class.
Courtney Armstrong is a Licensed Professional Counselor as well as a Master Practitioner and Associate Trainer in Rapid Resolution Therapy. She has a private counseling practice in Chattanooga, TN where she specializes in treating trauma, anxiety, and grief. To contact Courtney, visit www.courtneyarmstronglpc.com.
Is the five-stage model of grief overstated? Yes, according to Dr. George Bonanno. In his recent book, The Other Side of Sadness, Dr. Bonanno notes the current scientific literature has found no evidence that this 5-stage model exists for the bereaved.
When Kubler-Ross developed the 5-stage model, she was studying people who had a terminal illness, grappling with their own mortality. Kubler-Ross believed people passed through these five stages: 1) denial, 2) anger, 3) bargaining, 4) depression, and 5) acceptance. But, grief related to the passing of a loved one appears to follow a different course.
Rather than the 5-stage model, several scientific studies indicate that people go through more of a wave-like pattern between two processes: loss-oriented and restoration-oriented. (see Stroebe and Schut, 1999, 2000, 2001).
During loss-oriented waves, the bereaved person focuses on thoughts and feelings about their loved one. At these times, the bereaved tends to appraise the meaning of the loss, the relationship, and spiritual beliefs. In contrast, during restoration-oriented waves the bereaved person focuses on practical matters of readjusting to daily life. Moreover, these restoration-oriented waves involve moving forward with life, revising one’s identity, and engaging in other relationships and activities.
Knowing this oscillation pattern is “the norm” is useful because so often bereaved people question what they’re feeling. Bonanno states, “Bereavement is essentially a stress reaction, an attempt by our minds and bodies to deal with the perception of a threat to our well-being…. Relentless grief would be overwhelming. Grief is tolerable, actually, only because it comes and goes in kind of an oscillation.”
Bonanno’s research also notes most people are resilient and adjust to loss fairly well. Even though it’s normal to have waves of profound sadness as we’re adjusting to the passing of a loved one, Bonnano reports that only 10-15% of bereaved people actually struggle with prolonged grief.
Those of you who have studied with Jon Connelly, LCSW, Ph. D. know that he also disagrees with the 5-stage model. Dr. Connelly believes grief is essentially caused by the perception of loss. However, eliminating the perception of loss significantly reduces grief and suffering.
As Dr. Connelly thinks of it, “All you ever get from someone is experiences you acquire as a result of being with them. No one can take that away from you, you’ll never lose those experiences. Furthermore, you can’t lose things that never happened. So, in a sense you really haven’t lost anything.” He then helps bring the person into an experience of ongoing connection with their loved one, illustrating that it is not lost.
My intention is not to minimize the experience of the death of a loved one. Rather, it is to help us understand typical grief experiences, and to know most of us come out on the other side alright.
Please share your opinions about healthy ways to cope with grief.
Nat'l Institute of Mental Health, NIH Medical Arts
Did you know that you don’t have to use EMDR or painful exposure techniques to clear the emotional charge of a traumatic memory? All that is required is keeping the client “emotionally present” as they are describing the details of the event.
This concept was introduced to me many years ago by Dr. Jon Connelly. Now, neuroscience discoveries, and trauma researchers like Bessel van der Kolk, MD and Dan Siegel, MD are coming to similar conclusions.
Why does this work? I believe it works because when we keep the client emotionally present, we are helping to prevent the amygdala from activating the fight/flight response. The amygdala is the little almond shaped structure in the mid-brain that is triggered if the deeper mind senses danger. (See the Amygdaloids video on this blog for more info about this.)
The problem is, when the amygdala and fight/flight response go into high gear, the brain inhibits the function of the hippocampus and parts of the pre-frontal cortex. The hippocampus and certain aspects of the pre-frontal cortex are responsible for integrating memory and tempering emotional responses. If these parts of the brain are “off-line,” then the memory stays seared into the deeper brain as a non-verbal, implicit, felt memory.
When a memory stays in this implicit form, associated sensory details like smells, times of year, sounds, and visual images can trigger the same feelings of terror as the original event. However, these triggers are often “unconscious” to the client.
One goal of any trauma therapy is to integrate the traumatic memory over into conscious, explicit memory. To do this, we have to keep the hippocampus and pre-frontal cortex open and on-line. If you have the client emotionally re-live the event, guess what? You inadvertently activate the fight/flight response right there in the session and cause the hippocampus and pre-frontal cortex to go offline again.
“Recollecting’s not forgetting, it’s vivid rehearsal of pain. It keeps fear in my thoughts. It reminds me of that day. It keeps fear in my brain.” The Amygdaloids, from their song Fearing.
For a client to recall a traumatic event without “vivid rehearsal of pain,” you have to use tools that keep them emotionally responding to the present situation. This seems to allow the deeper brain/amygdala to realize the event is over so that it no longer fires off the fight/flight response at the mere recollection of the event’s details.
This has huge implications for how we practice psychotherapy and I am actively staying on top of research related to this phenomena.
Courtney Armstrong is a Licensed Professional Counselor who specializes in treating trauma, anxiety, and grief. She has a private practice in Chattanooga, TN and trains mental health professionals in an approach called Rapid Resolution Therapy. To contact Courtney, visit www.courtneyarmstronglpc.com.
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