Practical Brain-Focused Strategies for Working with Depression

Transcription

1 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 1 Practical Brain-Focused Strategies for Working with Depression How to Ignite the Depression-Battling Part of the Brain with Elisha Goldstein, PhD National Institute for the Clinical Application of Behavioral Medicine

2 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 2 Practical Brain-Focused Strategies for Working with Depression: Elisha Goldstein, PhD How to Ignite the Depression-Battling Part of the Brain Dr. Goldstein: Now, we ll look at how the brain changes. There are three ways to consider how the brain changes some of you may be very familiar with these. We know that how ever the brain is active in a particular moment influences our natural perception of things. We also know that we can use our mental perception, like our moment-to-moment awareness and choice to create different states to shift the activity in the brain and ongoing, if we intentionally practice and repeat that over time, we might experience more trait-dependent neuroplasticity. Neurons that fire together wire together, and that all comes with intention, effort, and repetition. What kind of learning are we after here? Neurons that fire together wire together, and that all comes with intention, effort, and repetition. There are different kinds of learning: there s explicit learning, which is our memorization of facts and general knowledge. There s implicit learning, which is all the stuff we don t have to think about we just do it automatically. Explicit learning is our memorization of facts and general knowledge. So, this isn t about learning to respond versus react that oftentimes is brought up in the field of mindfulness or in the field of psychology. It s not about that at all. Implicit learning is about how to train a healthier type of reactivity that s the key here. We re going to react no matter what, but we want it to be a healthier type of reactivity. Implicit memory helps us break down those old emotional patterns and helps us have a healthier type of reactivity that s more optimal for our resiliency. Implicit learning is about how to train a healthier type of reactivity.

3 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 3 One way of even considering or thinking about this is looking at the difference between explicit and implicit memory and you can do this with your clients. Imagine that you have a keyboard in front of you, and you can do this right now you might even have a keyboard in front of you. Without looking at the keyboard, just put your fingers on the keyboard or just make an imaginary keyboard in front of you, and write, I am home just type that out in an imaginary way. If you do that, you ll notice that it s a pretty easy task to do for most people because somehow they know exactly where all the keys are on the keyboard. But if I asked you now, without looking at a keyboard, to recite the middle row of the keyboard, you might have a more difficult time with that one is implicit memory and one is explicit memory. What we don t want to have to do is think too much about what we need to do how to ignite these natural antidepressants. What we want to do is have that happen automatically within us. We want the intention, practice and repetition to happen automatically just like learning how to type on a keyboard. We don t want to have to think too much about how to ignite these natural antidepressants. And we can do that with all the various natural antidepressants that we ll be learning about. Let s jump in now to the first natural antidepressant. The first one has to do with tuning the heart learning how to tune the heart. Before we even get into mindfulness, I ll discuss some of the neuroscience behind it you may have had a lot of experience with mindfulness, or you may be new to mindfulness. The first natural antidepressant has to do with tuning the heart. That doesn t really matter, because I m going to show you some different ways to integrate mindfulness whether you re experienced or new to it. Tuning the heart is an important beginning. In tuning the heart, the one thing I want you to consider right now and this is something that you can do with your clients too is just to warm up.

4 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 4 One way to tune the heart is to think about, right now, someone in your life who makes you smile. This could be a person or an animal someone you feel a real kinship with or a real connection to. Just visualize them in your mind. It could be, again, a person, an animal and just for now, I would say, someone who s living. Picture them in your mind, and as you picture this person or maybe group of people, consider what is it about this person that you like or love so much? The more you visualize that and get into it, the better, and the more you start to create some kindling for the heart. So that s a bit of a warm-up practice. The next step to that practice might be, and this would deepen it further, is to take it out of the intrapersonal space and bring it into the interpersonal space. One way of doing that is by using your technology perhaps, or in person if the person is around and go ahead and text or . You can pause this right now just text or that person and say, or tell them what it is that makes you so appreciate them. Actually do that go ahead and just do that right now. Why not? We never know what s coming next, and so why not express that gratitude that appreciation? Then notice how it feels to do this. Again, you can pause this if the person is not in your present area and if you re not driving, take out your phone or your or whatever it might be and just chat to them and say, This is what I really appreciate about you. Sometimes I ll do this with my clients actually in the room right there. I ll also do this with hundreds or a thousand people when I m speaking to them in a room and that becomes really something magnanimous! If you can imagine all the people that are engaged in this course right now or will be over time, and all these people will be doing this practice right now what a spreading ripple effect of tuning the heart! Whatever you notice from this practice, just have that experience and take a moment and just enjoy it.

5 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 5 So, there are four ways to tune the heart: We can do it toward our pain that s self-compassion. We can do it toward others pain that s compassion. We can do it toward our joy feeling good about our good Whatever you notice from this practice, just have that experience and take a moment and just enjoy it. experiences. We can do it through other people s joy feeling good about their experiences. Now, let s jump into what it means to have warmth toward pain tuning the heart. This is one of the natural antidepressants one of the natural ways to work with depression is helping people tune their hearts. What I ve found is that self-compassion is a key aspect that s sometimes left out explicitly in many mindfulness programs. Allowing people to have the scaffolding to integrate the practice of self-compassion plays a key part, and we ll talk about some of the neuroscience behind that. Many of you might have heard of Matthieu Ricard. He was French, got a doctorate at the Pasteur Institute, went through all this schooling, and then just gave it up and became a monk in the Himalayas. He had quite a deep practice and was brought back with the Dalai Lama to Richie Davidson s lab to study what goes on in his brain when he practices. When he did a more compassion-based practice, he had this massive left prefrontal shift of activity going on. One thing we notice, and we ll discuss this later when we talk about mindfulness, is that mindfulness also Mindfulness also creates a left prefrontal shift of activity. creates a left prefrontal shift of activity it s fascinating. There are not any current studies into the neuroscience of selfcompassion, but one thing we know is we can sometimes extrapolate and make a fairly simple leap, which we can do now: caring ignites a particular part of the brain, and caring in the face of suffering does that as well. We can make that leap because that is our experience in working with self-compassion.

6 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 6 Rumi, a 13th-century Sufi poet that you might be familiar with, said, Grief can be the garden of compassion Grief can be the garden of compassion. If you keep your heart open through everything, your pain can become your greatest ally in your life s search for love and wisdom. So, there it is how ever difficult things can be, the garden of compassion is Caring ignites a particular part of the brain, and caring in the face of suffering does that as well. there. One thing we know also, just so we are clear about more compassion-based work, is that there s been an association, a correlation, with a reduction of cellular inflammation. When we re feeling connected and we feel a sense of purpose and meaning in life, this is associated with reduced cellular inflammation. Barbara Fredrickson at the University of North Carolina (UNC) and Steve Cole of UCLA showed in their study that eudemonia, which is a feeling of connectedness, a sense of meaning and purpose in life, and a very good, very enduring sense of well-being, is connected with reduced cellular inflammation. People who just had positive experiences defined as hedonic happiness showed higher cellular inflammation. It s good to have those hedonic experiences, but it sounds like eudemonic happiness is even a more enduring and lasting sense of well-being. Eudemonic happiness is important it espouses a sense of connection and compassion. As it turns out, compassion also increases vagal tone, and again, we are looking at that more compassionbased work being associated with higher vagal tone. When we talk about self-compassion, there s some neuroscience behind it. Self-compassion is the ability to recognize there s a sense of common humanity. There s no single person who has suffered in this way that not another single person has. Self-compassion is the ability to recognize: I m suffering with this inclination to want to support myself, and I m not alone in this. There s this sense of a common humanity. There s no single person who has suffered in a way that not another single person has.

7 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 7 Most likely, and statistically, if someone s struggling with anxiety and depression at certain levels stress, family issues, trauma, whatever it might be thousands and thousands and thousands of other people in that very same moment are experiencing something similar. So, the common humanity piece is important. Self-compassion has also been, in some studies, shown to be inversely correlated with depression. Self-compassion has been show to be inversely correlated with depression. What that means is that when depression is high, self-compassion is low, and when self-compassion is high, depression is low and that certainly makes sense. It makes sense to me, with people who have struggled with recurrent depression over time, to not just allow self-compassion to be caught not taught, which is sometimes said within certain mindfulness programs. Instead, what I ve found, in working with people with depression individually and in groups, is that when you re starting to teach self-compassion, sometimes it s difficult initially, but then there s a thirsting for it almost at the same time. It can be so healing and so adaptive, and it just makes sense when we start seeing these studies that show compassion-based work creating this left prefrontal shift and increasing vagal tone. Physiologically, it just starts to feel good opening up. When we re talking about self-compassion, we can t help but talk about that with compassion because there s vulnerability someone has to be able to trust enough to be able to touch a wound that s within them, an emotional wound. They have to be able to learn how to pay attention to it, understand what s needed, and give themselves what they need. Ultimately, trust is what comes in. We start to build and learn how to trust ourselves. And, more importantly, remember when we talked about that three-legged stool of heart, mindfulness and cultivation? We have to start to really cultivate the heart here because it takes courage to be with what s difficult to learn how to pay attention to what s difficult in a particular way.

8 Practical Brain-Focused Strategies for Working with Depression Video 4 - Transcript - pg. 8 Again, the 13th-century Sufi poet Rumi said, Don t turn away. Keep your gaze on the bandaged place. That s where the light enters. The vulnerability is where the gold is. So, we work with that with self-compassion.