Comprehensive Course in Interpersonal Neurobiology. Clinical CAT 1. Conceptualization 2. Assessment 3. Treatment

Transcription

1 A Few Brief Words of Orientation and Welcome: This set of notes is a highlight of key elements of the course and is not a comprehensive outline or summary. The act of taking notes during the course, which can be added to these highlights, may activate your hippocampus and strengthen the encoding of memory for the content. Engaging in the experiential exercises will likely also widen your learning, creating motor and sensory bodily memories that then can become woven with conceptual and clinical discussions for a broader and more rewarding learning experience. Enjoy! INTRODUCTION TO THIS COURSE: Comprehensive Course in Interpersonal Neurobiology (0:01-24:18) Consilience: Assessing the universal findings across fields and disciplines Interpersonal neurobiology (IPNB) as a framework Clinical CAT 1. Conceptualization 2. Assessment 3. Treatment Mind, Embodied Brain, and Relationships (28:24-1:03:56) Mind Brain Relationships Triangle of Well- Being Mind Your Brain, Inc

2 MIND, PART I: Electro- chemical energy flow is the essence of neural firing patterns that underlie the brain aspect of experience Mind: An Emergent Property of Energy Flow (0:01-27:34) The mind has several facets, each of which may be an emergent property of energy and information flow. In this way, the system of mind may be how energy and information flow within us within the body and between us between our bodily selves and the larger world. This system of mind has the three features of a complex system: Features of a Complex System 1. Open to external influence 2. Chaos capable 3. Nonlinear The 4 Facets of Mind 1. Information processing 2. Consciousness 3. Subjective experience 4. Emergent and self- organization Complex systems have self- organization as a recursive, emergent property We can propose that one facet of mind can be defined as an embodied and relational, emergent, self- organizing process that regulates energy and information flow Mind: Self- organization and Integration (27:35-50:35) Regulation includes monitoring and modifying When a system is not optimally self- organizing, the system veers towards rigidity, chaos, or both Optimal self- organization involves the integration of elements of the system leading to harmony described as a FACES flow: Mind Your Brain, Inc

3 FACES Flow Flexible Adaptive Coherent Energized Stable Every symptom of every disorder listed in the Diagnostic Statistical Manual (DSM- V) can be reframed in terms of chaos and rigidity Integration: The differentiation and linkage of parts of a system Mind: Consciousness (50:36-58:42) The subjective experience or felt texture of being aware can be thought of as a prime something that is not reducible to something else Two Levels of Reality, According to Physics 1. Newtonian The study of physical laws that describe the interactions and motion of matter with systems of forces that can be determined by basic mathematical formulas 2. Quantum The study of reality, seen most readily on the scale of subatomic particles, in which it is most readily observed, though quantum properties have been demonstrated even for larger objectives such as matter Consciousness: The subjective experience of knowing Mind: Subjective Experience (58:43-1:05:56) Subjective experience: The internal texture of lived life; not observable directly by others Mind Your Brain, Inc

4 A + B AB An emergent property, like AB, cannot be reduced to A and B alone: The properties of water cannot be reduced to Hydrogen and Oxygen s individual properties, even though water is compose of 2 Hydrogens and 1 Oxygen Mind: Information Processing (1:05:57-1:18:15) We can view cognition as the way in which we experience symbolic patterns of energy. Some fields speak of the 4 Fs: The 4 Es of Cognition 1. Embodied 2. Embedded 3. Extended 4. Enacted Attention directs energy flow; emotion and many other inner and interpersonal factors influence attention Focal attention occurs within awareness; nonfocal attention occurs outside of awareness Awareness of Breath Practice (1:18:16-1:37:16) A mindfulness practice in which we pay attention to our moment- to- moment experience See if you can find compassion if your mind wanders; gently guide it back to your intended focus Sensing vs. observing Name it to tame it in context of distractions, refocusing your attention back to your intention Mind Your Brain, Inc

5 MIND, PART 2: The Interrogatives: The Who, What, When, Where, Why and How of the Mind (0:01-27:36) What: Emergent, self- organizing process of energy and information flow as well as information processing, subjective experience and consciousness the four facets of mind Top- Down Process Bottom- Up Process Learned prior to current experience; influences interpretation of sensory experience into perception, cognition, and planning The raw flow of energy at the root of experience; Energy patterns before learning; A beginner s mind experiencing as if it were the first encounter Where: Throughout the embodied brain and in relationships also known as within and between When: The present moment, but there may be a differential accounting for the directionality of change known as The Arrow of Time Who: Both a conduit (bottom- up process) and constructor (top- down process) of experience How: Through varying degrees of integration; impaired integration brings dysfunction, while integration brings well- being Why: A hypothesis is to bring greater integration and well- being into the world Mindsight (27:37-37:56) The Three Components of Mindsight Insight: Reflecting with awareness by focusing attention on the internal, subjective world of one s own interior mental experience, including feelings, thoughts, memories Empathy: Sensing the inner experience of another within one's own mind; forming a mental map of another; feeling felt by an empathic other is the foundation of a supportive relationship Integration: The differentiation or specialization, and, ultimately, linkage of systems including the brain and interpersonal relationships; without integration, chaos, rigidity, or both emerge, resulting in a state of mental dysfunction; with integration, harmony emerges with flexibility, adaptability, coherence, stability, and energy (a FACES flow) Mind Your Brain, Inc

6 Eye sight (for the physical world visible to the eye) vs. mindsight (for sensing the mind of self and other) Integration made visible is kindness, compassion, and well- being SIFTing Your Mind Sensations Images Feelings Thoughts Triception and the Window of Tolerance (37:57-57:46) Triception: The ability to perceive the mind, embodied brain, and relationships the triangle of human experience Integration {Adaptive Function & Harmony} RIGIDITY Window of Tolerance Integrative Movement I: Warm up, Step 1 and 2 (57:47-1:08:05) Strengthening monitoring skills Warm up: Allow energy flow to begin by tapping along the body from the arms, down the torso, through the legs, and back up Step 1: Arms slowly move up and down Step 2: Hands at chi or grounding point Mind Your Brain, Inc

7 THE EMODIED BRAIN: The Brain: Developmental Neurobiology (0:01-28:19) Epigenetics: How experience changes gene expression Temperament: The innate propensities of the nervous system to respond in a certain way to internal and external stimuli As neurons fire together, they are more apt to wire together, building neural networks of interconnected neurons and neural circuits Pruning: The removal of neural connections not being used, to allow specialization: Supports differentiation Myelination: The strengthening of neural connections by the addition of myelin: Supports linkage The ESSENCE of Adolescence ES Emotional Spark Active emotional response that influences reasoning and behavior Downside: Moodiness, irritability, sensitive emotional states Upside: Passion and energy SE Social Engagement Driven toward peers and away from parents Downside: Risk of sacrificing personal values in exchange for peer acceptance; total exclusion of adults Upside: Supportive relationships and development of lifelong relationship skills N Novelty Changes in the dopamine (reward) and limbic (evaluative) systems of the brain Downside: Risk of injury and death highest during this time Upside: Courage to explore and leave the familiarity and certainty of the home and enter the larger world CE Creative Exploration Mental pushing away from the status quo; new perspectives and ways of thinking; imagination Downside: Potential to feel out of place, disoriented, disillusion Upside: Innovations, creativity, and the ability to adapt Mind Your Brain, Inc

8 How the Brain Grows and Changes (28:20-41:00) General Lifespan Changes in Neural Function and Structure Synaptic Modulation The formation and modulation of neural synapses; (Synaptogenesis) Neurons that fire together, wire together Epigenetic Modulation (Epigenesis) Neurogenesis Myelination The alteration of the control of gene expression in this case via experience and learning that involves laying down of non- nucleic acid molecules on top of genes (which are comprised of DNA chains of nucleic acids) The generation of new neurons from neural stem cells which divide and can create new neurons early in life and especially in the hippocampus throughout the lifespan The laying down of a myelin sheath around interconnected nerve fibers, leading to increased firing speed and enhanced coordination of neural firing SNAG: Increasing Integration Stimulate Neuronal Activation Growth Clinical Conceptualization, Assessment, and Treatment: Neuronal Growth and Development (Intentionally left blank for note taking) (41:01-51:08) Conceptualization: Assessment: Treatment: Mind Your Brain, Inc

9 The Mindsight Approach to Well- Being: A Comprehensive Course in Interpersonal Neurobiology Dr. Siegel s Hand Model of the Brain: The Brain in the Palm of Your Hand (51:09-1:14:24) Ancient neural circuitry establishes patterns of reaction to threat: The Four Fs of Brain Stem Reactivity Fight Flight Freeze Faint Clinical Conceptualization, Assessment, and Treatment: The Brain (1:14:25-1:40:59) Mind Your Brain, Inc

10 Conceptualization: Assessment: Treatment: RELATIONSHIPS, PART 1: Relationships: Connection Across the Lifespan (0:01-19:00) Relationship: The sharing of energy and information flow Empathy vs. compassion Integration the differentiation and linkage of parts of a system within the relationship is essential to understanding resonance, which is different from mirroring or giving up your individual needs and sense of differentiation Presence, Attunement, Resonance, and Trust (PART): Verbal and Nonverbal Communication (19:01-38:14) Presence Attunement Resonance The PART We Play in Relationships Openness; awareness of present moment experience Focus of attention on the internal world of self or other Being shaped by another Trust A deep sense of openness and reliability Connection refers to a process of mutual resonance occurring between two individuals, leading to attunement and a sense of we Mind Your Brain, Inc

11 7 Basic Nonverbal Components of Communication 1. Eye Contact 2. Facial Expression 3. Tone of Voice 4. Posture 5. Gesture 6. Timing 7. Intensity C L I F F Characteristics of Energy Change Contours Location Intensity (Amplitude) Frequency Form Integrative Movement II: Steps 3 and 4 (38:15-44:46) Step 3: Giving with generosity and humility, and receiving with gratitude and openness; embodied relational integration Step 4: Integrating me and we to create a sense of mwe; embodied identity integration PART: Presence (44:47-56:18) Presence is the portal to integration; an open, receptive awareness of the unfolding of moment-to-moment experience; the opposite of presence is unintentional mind-wandering PART: Attunement (56:18-1:20:18) Attunement: Focusing of attention on the internal world of another (interpersonal attunement) or the self (internal attunement) Mirror neurons may be automatically activated in response to perceptual input and involve the anticipation of another s motor action that can be called the SIMA process: SIMA = Sensory Implication of Motor Action SIMA enables the representation of another s intention and then the two processes of behavioral imitation and inner simulation, enabling resonance Mind Your Brain, Inc

12 PART: Resonance (1:20:19-1:36:32) RELATIONSHIPS, PART 2: Attunement to another s subjective experience interpersonal attunement allows for two individuals to resonate with one another to feel felt by each other As two people become joined as a larger whole in the process of resonance, the individual, differentiated nature of each person is not lost PART: Trust (0:01-16:17) States of safety vs. states of threat Trust creates a state of receptivity as the social engagement system is turned on and receptivity is diminished OATS = Others And the Self OWN = Observing, Witnessing, and Narrating Centralized, default-mode processing involves a midline system of the brain, including the posterior cingulate cortex (PCC), that can be described as the OWN circuit, which focuses on OATS Integration allows us to differentiate streams of energy, freeing us from default-mode processing being over-differentiated and dominating experience in the moment Relationships: Rupture and Repair (16:18-27:18) Ruptures are inevitable in relationships, and they can be thought of as opportunities for repair and the deepening of connection Relationships: Kindness, Compassion, and Empathy (27:19-49:09) Empathy has many facets, including feeling the feelings of another, perspective- taking, and cognitive understanding Compassion: The way in which we perceive the suffering of another, imagine how to help, and then take action to alleviate the suffering Mind Your Brain, Inc

13 Kindness: Acting with no expectation of getting something in return; honoring and supporting one another s vulnerabilities Relationships: Forgiveness (49:10-56:46) Forgiveness can be thought of as giving up all hope of a better past; acceptance Relationships: Reflective Dialogues (56:47-1:13:16) ATTACHMENT, PART 1: Mindsight tools help cultivate the ability to communicate through a receptive state, rather than a state of reactivity Learning to SIFT through our experiences supports reflective dialogues and integrated relationships Reflective Dialogue Sensations Images Feelings Thoughts The 4 Ss of Attachment (0:01-22:02) Attachments help us survive and thrive in infancy and childhood, and these attachment patterns become a working model for future relationships The 4 Ss of Building a Secure Attachment Seen Safe Soothed Secure The Field of Attachment Research (22:02-36:42) Attachment theory and attachment research Alloparenting refers to a shared, collaborative child-rearing approach that human being evolved to engage in, in which the child may form attachment relationships to several trusted care-giving figures Mind Your Brain, Inc

14 ATTACHMENT, PART 2: Strategies of Attachment (36:43-1:14:54) Attachment categories are context dependent, describing patterns and tendencies within a relationship Secure attachment patterns vs. non- secure attachment patterns Organized attachment patterns vs. disorganized attachment patterns Secure Attachment (0:01-36:36) Seen in 55-65% of the non- clinical US population Observations made in the Infant Strange Situation: The child is able to connect with the caregiver as a safe- base for exploration: The caregiver provides reliable safety, soothes the child in times of distress, and appropriately responds to the child s needs and nonverbal cues The 4 S s of Healthy Attachment Seen The child feels that his or her needs are being accurately perceived by a caregiver The mind of the child is seen beneath behavior Safe The child feels protected from harm The caregiver is not a source of terror Soothed The child is reliably comforted and calmed by the caregiver in times of stress, and ruptures are readily repaired Secure The child feels able to explore his or her environment, relying on the caregiver as a safe- base Secure Attachment: The Infant Strange Situation (36:37-58:11) Observations made in the Infant Strange Situation: The child is able to connect with the caregiver as a safe- base for exploration: The caregiver provides reliable safety, soothes the child in times of distress, and appropriately responds to the child s needs and nonverbal cues Mind Your Brain, Inc

15 Secure Attachment: The Adult Attachment Interview (58:12-1:42:43) ATTACHMENT, PART 3: How a parent has made sense of her or his own attachment experiences is the best predictor of how that parent s child will be attached to them A specific set of 20 questions that explore qualities of connection between the adult when a child and his or her caregiver(s) Adult narrative as observed in the AAI: Coherent autobiographical narrative Avoidant Attachment (0:01-38:11) Seen in 20-25% of the non- clinical US population Observed in the Infant Strange Situation: Distant emotional connection. The child learns not to depend on the caregiver for comfort. He or she may even detach from awareness of his or her bodily and emotional sensations. Adult narrative as observed in the AAI: Dismissing stance that past relationships do not affect the self; difficulty retrieving autobiographic memory Ambivalent Attachment (38:12-57:18) Seen in 10-15% of the non- clinical US population Observed in the Infant Strange Situation: The child feels uncertain as to whether his or her own needs will be met by the caregiver because the caregiver is inconsistent, unreliable, and at times emotionally intrusive Adult narrative as observed in the AAI: Incoherent narrative that is often filled with intrusion of leftover emotional experiences in a preoccupied stance Disorganized Attachment (57:19-1:49:08) Seen in 5-15% of the non- clinical US population Terror of the attachment figure leads to the activation of two opposing neural processes at the same time: Limbic system: Drive to move toward caregiver for protection Mind Your Brain, Inc

16 Brainstem circuit: Drive to move aware from source of terror This results in a single person, in one body, having two conflicting drives: one to move both toward and the other to move away from the caregiver at the same time, creating a fear without solution, or a biological paradox Adult narrative as observed in the AAI: Disoriented/unresolved loss or trauma in narrative due to the loss of orientation during narrative output around specific issues of trauma or loss Clinical Conceptualization, Assessment, and Treatment: Relationships, Attachment, and Interpersonal Connection (1:49:09-2:28:49) Conceptualization: Assessment: Treatment: DOMAINS OF INTEGRATION: CONSCIOUSNESS, PART 1: The 9 Domains of Integration (0:01-7:13) Integration of Consciousness (7:14-1:05:11) Consciousness: the process or ability of the experience of knowing, or awarenessing, which includes a prime of subjective experience Knowing: the process or experience of knowing The known: the entity that is filling awareness Mind Your Brain, Inc

17 Mindsight Tripod Presence = Pre + Sense Integrative Movement III: Step 5 and Step 6 (1:05:12-1:17:36) Step 5: Integrating a sense of what s practical and what s possible ideas and ideals Step 6: Vertically stretching energy out Awareness of Breath: Mindsight Lens (1:17:37-1:46:25) Mapping of the in- breath and out- breath; a SIMA matching DOMAINS OF INTEGRATION: CONSCIOUSNESS, PART 2: Introduction to Dr. Siegel s Wheel of Awareness Practice (0:01-20:12) The Wheel of Awareness practice differentiates the process of knowing from the known, and this integration of consciousness cultivates change as we systematically link differentiated parts with the focus of attention and adaptively flow through experiences The hub represents knowing The rim represents the known The spoke represents attention, the streaming of energy and information flow that, in this case, is focal attention happening within awareness Mind Your Brain, Inc

18 The Wheel of Awareness Practice (20:13-1:01:17) Create a quiet space for this guided practice Integration of Consciousness: The Science of the Wheel of Awareness Practice (1:01:18-1:37:28) When we intentionally focus awareness on the unfolding of moment- to- moment experience, we come to realize that mental experience is not the totality of reality, nor is it permanent There are many thoughts and feelings beyond those we are aware of, and they come and go Integrating consciousness may be at the heart of other practices as well, such as those that develop mindful awareness Through mindfulness, we strengthen the capacity for emotional regulation, conscious decision making, insight, and empathy, bringing more balance, harmony, and well- being into daily life DOMAINS OF INTEGRATION: CONSCIOUSNESS, PART 3: The Plane of Possibility (0:01-53:01) Quantum aspects of reality are based on probabilities, not certainties; mindfulness practices, like the wheel of awareness practice, strengthen our abilities to be consciously aware. Energy can be defined as the capacity to do something, and a range of energy probabilities from near 0% to 100% exists 100% probability = Certainty; these are peaks of actualization Near 0% probability = Uncertainty, or infinite possibility, which is full of potentialities but devoid of realized actualities; in this way, it is both empty and full Mind Your Brain, Inc

19 Plateaus of probability constrain these options as mood or intention; specific thoughts or emotions or memories are depicted as peaks of activation the transformation of possibility into actuality; sub- peak values reveal thinking, emoting or remembering One hypothesis drawn from first- person accounts of the Wheel of Awareness practice: the knowing of awareness arises when the energy probability distribution curve position is in the infinite plane of possibility free from top- down influence and, instead, a source in openness and the source of possibilities Clinical Conceptualization, Assessment, and Treatment: The Integration of Consciousness (53:02-1:23:17) Conceptualization: Assessment: Treatment: DOMAINS OF INTEGRATION: BILATERAL, PART 1: Bilateral Integration (0:01-17:13) Linking the differentiated parts of the left and right hemispheres via the corpus callosum to make sense of, and find meaning in, an experience The cortex in general, both the right and left hemispheres, has columns from which information is constructed; some anatomic analyses suggest that the right hemispheric columns integrate more horizontally, across columns, allowing for cross- column construction to be more interconnected, while the left hemispheric columns integrate vertically, creating the deep construction of information and Mind Your Brain, Inc

20 The Mindsight Approach to Well- Being: A Comprehensive Course in Interpersonal Neurobiology the experience of analysis down- breaking of information within a set of more specific columnar neural processes Bilateral Integration: Asymmetry of Structure and Function (17:14-42:09) The right mode, which is dominant for nonverbal communication and autobiographical processing and memory, develops first The left mode, which mediates more linear, linguistic, logic- based processing and memory, develops later Bilateral Development (42:10-1:15:22) Right hemispheric mode develops earlier and includes more holistic processing, such as nonverbal signals, representation of the interior of the body, autobiographical memory, and possibly stress response, and plays a primary role in sensing the mind of others Left hemispheric mode develops later and includes more linear processing, such as linguistic language, logic, analysis, and factual memory Two Layers of Memory Explicit Memory Similar to declarative memory that can be stated in words Implicit Memory Similar to non- declarative memory Episodic: Specific personal experience, dominant in the right hemisphere Semantic: Factual information, dominant in the left hemisphere Perception Bodily Sensations Emotion Behavioral/Motor Response Generalizations as Schema or Mental Models Priming Bilaterality and Learning (1:15:23-1:27:13) Both hemispheres are important and contribute to creativity, connection, and learning Mind Your Brain, Inc

21 DOMAINS OF INTEGRATION: BILATERAL, PART 2: Attachment and Bilaterality (0:01-20:31) Needs and feelings may be correlated to right mode, and switching to left mode dominant processing may be a way of adapting to difficult relational contexts Clinical Conceptualization, Assessment, and Treatment: Bilateral Integration (20:32-45:45) Conceptualization: Assessment: Treatment: Case Example (1:06:04-1:06:08) Integrative Movement IV: Step 7 (1:06:09-1:13:29) Step 7: Bilateral movement of hands DOMAINS OF INTEGRATION: VERTICAL: Vertical Integration (0:01-42:54) Mind Your Brain, Inc

22 Awareness of the body, and includes the reinterpretation of physiological stress reaction Dorsal dive refers to our survival reaction to faint the polyvagal theory; fainting, or feigning death, is one of the responses mammals are neurologically wired to have, along with freeze, fight, and flee No/Yes Exercise Clinical Conceptualization, Assessment, and Treatment: Vertical Integration (42:55-1:01:38) Conceptualization: Assessment: Treatment: Case Example (1:01:39-1:11:03) DOMAINS OF INTEGRATION: MEMORY, PART 1: Memory Integration (0:01-19:06) Stages of Memory 1 Encoding Internal or External stimuli translated into electrochemical energy, resulting in neural firing 2 Storage Neural firing results in temporary, chemical changes or long term, structural changes in neural networking 3 Retrieval Reactivation of specific neural networks, which is associated with hippocampal activity if explicit memory involved Mind Your Brain, Inc

23 Implicit Memory Explicit Memory Implicit Memory Two Layers of Memory Similar to declarative memory that can be stated in words Similar to non- declarative memory (19:07-49:31) Episodic: Specific personal experience, dominant in the right hemisphere Semantic: Factual information, dominant in the left hemisphere Perception Bodily Sensations Emotion Behavioral/Motor Response Generalizations as Schema or Mental Models Priming Neuronal foundations of mental representations result in a generalization, or schema a mental model of experience, which influences the ways perception of ongoing experiences in the future will be shaped While schemas allow us to make sense of experiences quickly and efficiently, they also affect the way we experience the world through non- conscious assumptions and expectations Ecphoric sensation is the feeling that a recalled memory is coming from the past; all retrieval involves awareness; not all retrieval involving awareness involves an ecphoric sensation Implicit memory, when retrieved in its pure form, can be fully in consciousness and yet not have an ecphoric sensation; therefore, stating implicit memory is synonymous with unconscious memory is not really accurate The hippocampus can be usurped by focal attention being divided during dissociation and also by the stress hormone cortisol that can inhibit explicit encoding of information via the hippocampus; however, cortisol does not inhibit implicit encoding and the adrenaline secreted during trauma can enhance implicit encoding Memory and Forgetting (49:32-1:08:55) Memory integration and cortical consolidation are the memory processes in which implicit memories are first brought into consciousness and then stored in a new explicit form, altering both the nervous system structure and the subjective experience connected to that memory Mind Your Brain, Inc

24 With consolidation, this newly processed explicit memory can ultimately move from long- term storage hippocampally dependent to permanent storage, becoming free of the hippocampus for retrieval and allegedly becoming woven into the cortical narratives of our lives Learning and Unlearning (1:08:56-1:31:55) Engram: A change in neural structure due to encoding that correlates to a change in memory; a neural net profile Using a dual- focus of attention, therapists can help clients focus one stream of attention on the original engram while also focusing a stream of attention to new learning, making a new neural configuration DOMAINS OF INTEGRATION: MEMORY, PART 2: Forgetting and Remembering (0:01-25:23) From an IPNB framework, repression can be thought of as the automatic blockage from access to retrieval of an item encoded in stored memory; it may be preceded by suppression the intentional act of forgetting Suppression refer to putting energy into actively preventing retrieval; something originally accessible can become inaccessible, whereas in dissociation, a memory is not explicitly available for retrieval Memory: Emotion, Anticipation, and States (25:24-52:54) The brain is an anticipation machine; the mind creates memory for the future or prospective memory The brain is a pattern detector, seeking out predictable sequences or patterns of perceptual input Memory is also influenced by emotion a shift in integration and overall states of mind Clinical Conceptualization, Assessment, and Treatment: Memory (52:55-1:13:09) Conceptualization: Mind Your Brain, Inc

25 Assessment: Treatment: Case Example (1:13:10-1:23:19) Integrative Movement V: Step 8 (1:23:20-1:31:12) Step 8: Tides rolling in and out; an embodied memory integration DOMAINS OF INTEGRATION: NARRATIVE, PART 1: Narrative Integration (0:01-37:41) Narrative refers to an extraction of meaning, often through engaged reflection Stories play a developmental and teaching role, as they allow us to have an experience, to share through trust and connection, and to learn from our own and other s experiences Jerome Bruner highlights two aspects of narrative: Landscape of action is the content, or what happens in the outer, visible world Landscape of consciousness is the internal state and mental processes that coincide with the event in the internal world, often invisible to the eye alone A story is the way in which a person makes sense of violations to canonical expectations (expectations learned from prior experience), which is then expressed in the linear telling of a sequence of events with a landscape of action and a landscape of consciousness described in the narrative Mind Your Brain, Inc

26 Trauma and Narrative Resolution (55:42-1:21:01) How a parent has made sense of her or his own attachment experiences is the best predictor of how that parent s child s attachment will unfold in relationship to that particular parent We can shape our own narratives through neuroplasticity because of the emergent, self- organizing property of the mind: the way in which energy flows through the nervous system influences subjective experience and also recursively alters the nervous system itself We can t change the past, but we can change the way we make sense of the past and how that past then influences us in the present and future DOMAINS OF INTEGRATION: NARRATIVE, PART 2: Self and Evolving Narrative (0:01-21:16) We can begin to see how the self is not singular but more of a MWe (me + we) with a personal mindscape within and a shared mindsphere between Narrative: Reframing Stress, Grit, and Mindset (21:17-47:59) While a fixed mindset views a difficult situation as a threat, a growth mindset instead, views a difficult situation as a challenge and an opportunity to grow Passion, purpose, and persistence result in grit Today, the concept of stress has been generalized and broadly categorized into good vs. bad stress; high quantities and durations of stress are thought to be correlated with negative health outcomes, and the stress hormone cortisol is viewed as detrimental to health The physiological reaction of stress is not bad, and it is not good; it is, most often, what we make of it Using the concept of integration as the foundation for reframing stress even when initial physiological markers of stress remain the same we can begin to regulate and self- organize in a way that creates adaptive coping skills and harmony A meaningful life is inevitably a stressful life, as stress is the physiological state when something important is at stake Mind Your Brain, Inc

27 Clinical Conceptualization, Assessment, and Treatment: Narrative Integration (48:00-1:04:17) Conceptualization: Assessment: Treatment: Case Example (1:04:18-1:19:14) DOMAINS OF INTEGRATION: STATE, PART 1: State Integration (0:01-10:24) A state is a way of being, and there are many different facets of being Self- states repeat over time and build the foundations of who we are Internal state integration refers to coherence within a given state Between state integration refers to collaboration across states Taking a multiplicity view of self, rather than divided states of the self or a view that the self needs to be unitary and without differentiated aspects; embracing the many facets of self Mind Your Brain, Inc

28 Qualities of State of Mind (10:25-31:02) The A- B- C- D- E of State of Mind Associations Beliefs Cognitive patterns Developmental period Emotions State Integration: Layers, Aspects, and Parts (31:03-58:12) While Internal Family Systems theory (IFS) identifies specific parts of the self, IPNB views the differentiated states of a person as being more like aspects Hypothesis: If mindsight even with high Adverse Childhood Experience Scale (ACES) scores is applied to make sense of and extract meaning from traumatic experience, physiological outcomes such as immune system function and hemispheric integration - may be altered in a positive direction DOMAINS OF INTEGRATION: STATE, PART 2: State Integration: Dissociation (0:01-1:15:46) Dissociation, a fundamental process that involves the impediment to integration of psychological functions and has been shown to be an outcome of disorganized attachment earlier in life Dissociation may be a risk factor for developing PTSD if exposed to overwhelming and life-threatening events Dissociative barriers isolate the cluster of neural firing that embed specific behavioral responses, emotions, bodily sensations, mental models, and priming, resulting in a relatively autonomous, dissociated state of mind that may have enduring features Clinical Conceptualization, Assessment, and Treatment: State Integration (1:15:47-1:38:27) Conceptualization: Mind Your Brain, Inc

29 Assessment: Treatment: Case Example (1:38:28-1:58:55) DOMAINS OF INTEGRATION: INTERPERSONAL: Interpersonal Integration (0:01-29:17) Sharing of one s own internal experience with others, which provides opportunity for connection and empathic attunement and the source of the experience of feeling felt Romantic Relationships (29:18-1:01:17) While romantic love involves biological systems such as serotonin, oxytocin, and the HPA axis and sexual hormones, dopamine a central neurotransmitter for motivational circuits related to drive and satisfaction may be a key aspect of romance (see the work of Helen Fisher, Ph.D.) In a sexual context, resonance refers to two individuals consensually bringing their sexual drives together, becoming coupled as one; two independent systems influence each other, but do not become each other, resulting in a form of integration An ideal love relationship would involve romantic love, erotic love, and attachment love, as each involves a different form of integration Interlocking States (31:03-1:22:32) Interlocking states occur when the adapted attachment strategy of each partner triggers similar reactions that are enduring obstacles to integration and a sense of well- being While you may be drawn to someone who offers what you may have been missing in terms of childhood needs, both individuals can use this relationship as a foundation to grow and create integration honoring differences and supporting each other s vulnerabilities as they come Mind Your Brain, Inc

30 together and connect; within the relationship, an earned secure attachment can emerge, supporting healthy growth and long- lasting connection Clinical Conceptualization, Assessment, and Treatment: Interpersonal Integration (1:22:33-1:40:49) Conceptualization: Assessment: Treatment: Case Example (1:40:50-1:51:36) Integrative Movement VI: Steps 9 and 10 (1:51:37-2:02:32) Step 9: Embodied ocean currents that represent state integration Step 10: An embodied integration of consciousness, expanding and contracting energy, as the Thai Chi ball represents a parallel to the Wheel of Awareness, with its central hub and outer rim DOMAINS OF INTEGRATION: TEMPORAL: Temporal Integration (0:01-20:54) Facing the existential challenges of the mind s capacity to map a sense of time so that issues of longing for certainty, permanence, and immortality are linked to the reality of life s uncertainty, transience, and mortality Time also has the quality of an arrow of time for large (macrostate) assemblies like thoughts, memories, and emotions, but may also have the Mind Your Brain, Inc

31 arrow- free qualities for microstate configurations that may apply to the experience of awareness itself Entanglement, or non- locality, refers to the finding that changing the state of one entity instantaneously changes the patterns of a coupled ( entangled ) entity, like a paired electron in a physically distinct location; this suggests an interconnectedness that acts at a distance this is not considered a force (it moves faster than the speed of light), rather it is considered a coupling of related or connected entities of the universe and that physical distance or separation in space is actually not what it seems these interconnections reveal that space may not be what we perceive it to be and so a space- time block may have four dimensions embedded in it, making the interconnections with the now proven aspect of non- locality or entanglement make sense from a four- dimensional view Time: Newtonian and Quantum Levels (20:55-53:31) Quantum and Newtonian properties may be experienced differently with distinct mental processes, such as the difference between the knowing of awareness and the knowns of awareness the objects of consciousness Conscious observation: The act of observation of a photon the fundamental element of light energy collapses the wave function, reducing the state function: a photon can be a particle or acting like a probability distribution, like a wave The previously more commonly held Copenhagen Interpretation of quantum physics suggests that the act of being aware conscious observation changes energy patterns by altering the probability function from a wave and into a certainty (acting like a particle, no longer like a wave) Many physicists hold differing views, so this is a matter of heated debate Clinical Conceptualization, Assessment, and Treatment: Temporal Integration (53:32-1:15:31) Conceptualization: Assessment: Mind Your Brain, Inc

32 Treatment: Case Example (1:15:32-1:39:49) DOMAINS OF INTEGRATION: IDENTITY: Identity Integration (0:01-20:55) Sometimes dependent on the integration of the other eight domains, so was previously called transpirational integration, or breathing- across the other domains, the sense of who a person is can become more integrated by holding a transcendent worldview viewing the self as part of a larger, connected system of people and planet creating a sense of MWe Cultural Evolution: The idea that a culture is changing over time through changes in ideas that influence transformations in communication within individuals of a community Personal Identity (20:56-32:49) Becoming a part of a larger humanity, not merely a separate me, nor lost in membership as a we, but having an integrated sense of MWe Identity Integration: Belonging to a We (32:50-58:57) Example of the role of gender and sexuality as identity Primary identity of gender and sexual orientation are independent domains, and both of these domains can exist on a continuum of being Clinical Conceptualization, Assessment, and Treatment: Identity Integration (58:58-1:05:01) Conceptualization: Assessment: Mind Your Brain, Inc

33 Treatment: Case Example (1:05:02-1:11:25) Bringing Your Interpersonal Neurobiology Framework and Mindsight Approach Into Life and Clinical Practice (1:11:26-1:38:08) Mind Your Brain, Inc