Published on February 24, 2014
From neuroscience to ‗neuroart‘ Australian Somatic Psychotherapy Association (ASPA) Professional Development 2013 Werner Sattmann-Frese PhD
Werner Sattmann-Frese is a Senior Lecturer and CoProgram Manager at the Jansen Newman Institute (Think Education Group) in Sydney. Your feedback on this presentation would be appreciated. Werner can be contacted at firstname.lastname@example.org
Aims of this presentation • To present recent neuroscience research findings • To explore the usefulness of neuroscience in underpinning somatic psychotherapy • To explore in some detail why there is currently an emerging tiredness in relation to neuroscience among somatic psychotherapists • To determine the capacity of neuroscience to act as a driver for psychosocial and ecological change.
Questions • Has neuroscience as a whole the capacity to drive social, cultural, and ecological change? • Is it really useful as a confirmation of the value of psychotherapy? • Which of the numerous aspects of neuroscience can be used to support the necessary development of socially, culturally, and ecologically aware approaches to counselling and psychotherapy? • Let us explore these questions in a discussion after and during this presentation.
From the microscope to the ct-scan • In 1818 Johann Wilhelm Heinroth coined the term ‗psychosomatic medicine‘. • Shortly after the microscope was discovered, scientists started to look for and destroy the microscopically small enemies of humans rather than seeking to understand their roles in an ecological universe. • We are still trying to destroy microorganisms almost 200 years later. • Will neuroscience turn out to be another postponement of ecological consciousness?
What is neuroscience?
Neuroscience is socially constructed • Neuroscience is not a unified approach to generating understandings on mental and physical health and wellbeing. • It differs both in terms of perspectives and worldviews. • The next slide briefly outlines the wide range of perspectives.
Neuroscience areas • • • • • • • • Molecular and cellular neuroscience Affective neuroscience Cognitive and behavioural neuroscience Neuropsychiatry Developmental neuroscience Social neuroscience Cultural neuroscience Critical neuroscience
Neurobiology Scholars o Candace Pert o Alan Schore o Louis Cozolino o Jacques Fradin o Jaak Panksepp o Daniel Siegel o Colin Trevarthen o Ed Tronick o Humberto Maturana
The brain as mind
Neuroscience at a glance • In the past few decades, researchers have learned much about the fundamental workings of the brain, with tremendous gains in knowledge about the molecules that make it run. Scientists identified genes for receptor proteins that detect smell and taste. They determined that the stuff of memories is, literally, a cascade of biochemical changes at the connections, or synapses, between neurons. And belying an old view that the nervous system is hardwired from birth, experts found that its cells retain some capacity to adapt and reorganize in response to experience. • http://www.kavliprize.no/artikkel/vis.html?tid=27481
In a nutshell: • Neuroplasticity • New neurons grow and create connections throughout the lifespan • The whole body works like a highly complex selfregulating system • The brain is continually driven by our genetic blueprints and experiences via neuropeptides and by the integration of differentiated parts • Emotions (expression, mirroring, and sense making) are highly important factors in human development • The brain is programmed to be social
Brain hemispheres • The left brain is responsible for logic and is in charge of verbalizing internal thoughts and feelings. The left hemisphere is also responsible for creating our life story, our autobiographical narrative. • The right brain is predominantly non-verbal and is largely responsible for our perception of emotion, as well as mediation of the body's physiological and emotional state. "Retrieval of autobiographical memory appears to be mediated by the right hemisphere" (Solomon, 2003). Without this coherent narrative, we are less likely to be able to make sense of past traumatic experiences. • http://www.positivehumandevelopment.com/interpersona l-neurobiology.html
Frontal Cortex Corpus Callosum Planning, Strategizing, Logic, Judgment Connects Hemispheres Creativity and Problem Solving Source: Neurobiology of Addiction (2009) The University of Sydney – Faculty of Medicine Cerebellum Coordinates muscles/ movement and thinking processes Thalamus Nucleus accumbens Extended Amygdala Emotional responses: fear and anger Ventral tegmental area Locus coeruleus Hippocampus Forms Memories Coordinates thinking processes
Affective neuroscience • Emotions are thought to be related to activity in brain areas that direct our attention, motivate our behavior, and determine the significance of what is going on around us. Pioneering work by Paul Broca (1878) James Papez (1937), and Paul D. MacLean (1952) suggested that emotion is related to a group of structures in the center of the brain called the limbic system, which includes the hypothalamus, cingulate cortex, hippocampi, and other structures. • http://en.wikipedia.org/wiki/Affective_neuroscience
The importance of emotions • Biobehavioral scientists are increasingly recognizing the importance of emotion for the fundamental tasks of survival and adaptation (Damasio, 1994; Ekman & Davidson, 1994; Pinker, 1997). Emotion facilitates decision making, has significant influence on learning and memory, and provides the motivation for critical action in the face of environmental incentives. Emotion is also the stuff of individual differences. It is a key component, if not the major ingredient, for many of the fundamental dimensions of personality and vulnerability factors that govern risk for psychopathology. • http://psyphz.psych.wisc.edu/web/pubs/2000/Emotion_Plastici ty.pdf
Child maltreatment and the developing brain • http://neur2201.unsw.wikispaces.net/file/view/maltreatme nt+brain+develop+neuro+look.pdf • Maltreatment during childhood is viewed as experience that contributes to brain development, potentially leading to differences in brain anatomy and functioning.
Attachment • Early interpersonal experiences influence interpersonal functioning and methods of regulating emotional distress via ‗attachment working models‘ (Bowlby, 1980). • Secure attachment • Intergenerational attachment styles • Insecure attachment styles ▫ Avoidant attachment ▫ Ambivalent attachment ▫ Disorganised attachment
Attachment and affect regulation • In the last two decades, attachment theory (Bowlby, 1982/1969, 1973) has become one of the most important conceptual frameworks for understanding the process of affect regulation. Bowlby (1982/1969, 1973) highlighted the anxiety buffering and physical protection functions of close relationships, conceptualized proximity seeking as an alternative to instinctive ﬁght–ﬂight responses, and emphasized the importance of interpersonal experiences as a source of individual differences in affect regulation over the life span. • http://psychology.ucdavis.edu/labs/Shaver/site/Publi cations/mikulincerpere03.pdf
Complex trauma • Complex trauma can be caused by childhood abuse in all its forms as well as neglect and growing up with family violence or dysfunction. • Any form of violence experienced within the community – civil unrest, war trauma, genocide, cultural dislocation, sexual exploitation or retraumatisation of victims later in life can also cause complex trauma. • http://www.asca.org.au/displaycommon.cfm?an= 1&subarticlenbr=350
Trauma and brain integration • Traumatic experiences are associated with reduced ―cortical and sub-cortical areas‖ as well as reduced connectivity of left and right brain hemispheres (Perry, 1997). Research indicates this separation as being due to hindered growth of a brain structure called the corpus callosum, which connects the two hemispheres and enables neural integration to occur (Teicher, 2002; De Bellis et al., 1999a, 1999b). If the corpus callosum is unable to adequately integrate the left and right brain, a person‘s ability to achieve a coherent narrative of their life story is compromised (Solomon, 2003). • http://www.positivehumandevelopment.com/interper sonal-neurobiology.html
Making sense of trauma • Research has demonstrated that it is not the traumatic events in our lives that determine resiliency so much as how we make sense of those events that determine our ability to experience resiliency (Siegel, 1999). For example, if I were physically abused as a small child and my way of making sense of the abuse was that I was to blame, I might expect similar traumatic abuse from others when I make a mistake. However, if I were to make sense of the abuse by viewing my abuser as having anger issues that are not related to me ("They are the jerk, not me!), I might not expect others to abuse me in a similar manner. • http://www.positivehumandevelopment.com/interpersona l-neurobiology.html
Dysregulation and the right brain • Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders. • http://www.ncbi.nlm.nih.gov/pubmed/11929435
Making sense of the reduced growth • It makes sense to reason that the compromised integration between the two hemispheres actually protects a person from constantly feeling the full impact of the trauma he or she experienced. In this view it may be viewed as the neurological manifestation of neurosis.
Impact on cortex and limbic system • Research shows that children and adults with histories of child abuse can respond to minor triggers with a range of catastrophic reactions. This is because traumatised children (and adult survivors) become increasingly responsive to relatively minor stimuli as a result of decreased frontal lobe functioning (learning and problem solving) and increased limbic system (amygdala) sensitivity (impulsiveness) (Streeck-Fischer & van der Kolk, 2000). • http://asca.org.au/displaycommon.cfm?an=1&subart iclenbr=194
Emotional learning • Some of the most impressive evidence for brain plasticity is emotional learning (LeDoux, 1996). Plasticity in the neural circuitry underlying emotion is also likely to play an important role in understanding the impact of early environmental factors in influencing later individual differences and risk for psychopathology (Meaney et al., 1996). http://psyphz.psych.wisc.edu/web/pubs/2000/Em otion_Plasticity.pdf
Effects of relational trauma (1) • Early traumatic attachment takes place when infants and toddlers repeatedly encounter massive misattunement from caregivers who trigger (and do not repair) long-lasting intensely dysregulated states in the child. The growth-inhibiting environment of relational trauma generates dense and prolonged levels of negative affect associated with extremely stressful states of hyper- and hypoarousal. • http://www.allanschore.com/pdf/__SchoreDissociati on09.pdf (p.114)
Effects of relational trauma (2) • In self-defense the child severely restricts overt expression of attachment need and significantly reduces the output of the emotion-processing, limbic centered, attachment system. When the child is stressed, defensive functions are rapidly initiated that quickly shift the brain from interactive regulatory modes into long enduring, less complex autoregulatory modes. These patterns are primitive strategies for survival that remain online for long intervals of time, periods in which the developing brain is in a hypometabolic state that is detrimental to the substantial amounts of energy required for critical period biosynthetic processes. http://www.allanschore.com/pdf/__SchoreDissociation09 .pdf (p.114)
Let us briefly explore schizophrenia as an example:
Neurological features of schizophrenia • • • • • • • Significant loss of grey matter Enlarged amygdala Neurological abnormalities Enlarged ventricles in the brain Impaired cognitive function Decreased prefrontal brain function Impaired awareness of illness
Schizophrenia • Significant Loss of Brain Gray Matter: Individuals with schizophrenia, including those who have never been treated, have a reduced volume of gray matter in the brain, especially in the temporal and frontal lobes. Recently neuroscientists have detected gray matter loss of up to 25% (in some areas). • http://www.schizophrenia.com/disease.htm#hist ory
Symptoms suggestive of frontal lobe dysfunction • • • • • • • • Emotional dullness Impaired judgment Poor initiative, motivation, drive Lack of insight Difficulty in planning Impaired problem-solving/abstract reasoning Decreased concern for personal hygiene Social withdrawal • Source: Neurobiology and Schizophrenia, Godfrey D. Pearlson, Neuropsychiatry Research Center, Institute of Living, Yale University School of Medicine
11.05 Neurotransmitter involved in schizophrenia Dopamine-hypothesis of schizophrenia Clinical observations: • Conventional antipsychotic drugs inhibit D2 receptor. • Schizophrenia-like symptoms occur in amphetamine abusers, due to excessive DA release. • Baseline DA levels and stimulated release of DA are abnormal in mesolimbic systems of brains from schizophrenic patients. DA system plays a role in schizophrenia. However, it is likely not to be the only and/or main neurotransmitter system implicated. (Freedman 2003 N Engl J Med 349:1738) Source: www. mercaz.info/pclection/SCHIZOPHRENIA. ppt
Dopamine imbalances • Thus, the current predominant view is that DA systems in schizophrenia might be characterized by an imbalance between subcortical and cortical DA systems: subcortical mesolimbic DA projections might be hyperactive (resulting in hyperstimulation of D2 receptors and positive symptoms) while mesocortical DA projections to the PFC might be hypoactive (resulting in hypostimulation of D1 receptors, negative symptoms and cognitive impairment).
Questions: • Have these findings helped us in understanding the psychosocial causes of schizophrenia? • Are these findings useful for the therapeutic work with individuals afflicted with this condition? • Are dysfunctions of brain structures the causes of problematic perceptions or useful responses of the bodymind to organise survival in the face of high levels of trauma?
Proposed causes of schizophrenia • Research done during the past decade has revealed that schizophrenia is caused by a combination of genetic or biological predisposition as well as other factors such as prepregnancy factors, pregnancy stress, other prenatal factors, social stress, family stress or environmental stressors during a person's life. • http://www.schizophrenia.com/disease.htm#hist ory
Epidemiological features of schizophrenia • Individuals with a schizophrenic parent are about 10 times more likely to develop the condition than individuals with a parent without the condition (50 times when both parents are affected). • People born in spring have a 10% higher risk and people born in autumn have a 10% lower risk than people born in other seasons. • Individuals born and raised in big cities have a higher risk of developing the condition than individuals raised in the countryside. • http://www.nature.com/neuro/journal/v2/n4/full/nn04 99_295.html
Types of abuse • Childhood sexual abuse, for example, was associated with hallucinations, whilst being brought up in a children's home was associated with paranoia. The research further suggests a strong relationship between environment and the development of psychosis, and provides clues about the mechanisms leading to severe mental illness. • http://www.sciencedaily.com/releases/2012/04/1 20419102440.htm
Trauma and neglect • Persisting mental health problems are a common consequence of child abuse and neglect in adults. Mental health problems associated with past histories of child abuse and neglect include personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety disorders and psychosis (Afifi, Boman, Fleisher, & Sareen, 2009; Chapman et al., 2004; McQueen et al., 2009; Springer et al., 2007). • Depression is one of the most commonly occurring consequences of past abuse or neglect (KendallTackett, 2002). • http://www.aifs.gov.au/nch/pubs/sheets/rs20/rs20.ht ml
Events in depression • The hypothalamus registers distress from insults to the self • Its axons in the pituitary gland release the neuropeptide cortical release factor (CRF) • The presence of CRF in the gland stimulates the release of adenocorticotropic hormone (ACTH) • ACTH travels through the blood stream to the adrenal glands • These glands release the steroid corticosterone • The presence of this steroid is associated with depression • Permanent stimulation with ACTH causes the gland‘s receptors to shrink to avoid the release of steroids to increase well-being in the face of trauma
Norman Doidge: • Kandel argues that when psychotherapy changes people, "it presumably does so through learning, by producing changes in gene expression that alter the strength of synaptic connections, and structural changes that alter the anatomical pattern of interconnections between nerve cells of the brain." Psychotherapy works by going deep into the brain and its neurons and changing their structure by turning on the right genes (Doidge, 2007, p. 156).
Norman Doidge: • A study of depressed patients treated with interpersonal psychotherapy — a short-term treatment that is partially based on the theoretical work of two psychoanalysts, John Bowlby and Harry Stack Sullivan — showed that prefrontal brain activity normalized with treatment. • A more recent fMRI brain scan study of anxious patients with panic disorder found that the tendency of their limbic systems to be abnormally activated by potentially threatening stimuli was reduced following psychoanalytic psychotherapy (Doidge, 2007, p. 164).
Critique of affective neuroscience • • • • Brain centrism Focus on individuality and interiority Promotion of individual choice and autonomy Explaining the complexity of life in terms of ‗scanable‘ brain functions • Focus on mediating neural processes rather than on changing socioeconomic living conditions
Critical neuroscience • Most likely, much of the concern and revolutionary language about the radical changes imposed by neuroscience on society arise from the gap between actual findings in research and the representations of the findings. • Choudhury et al., Critical Neuroscience: Linking Neuroscience and Society Through Critical Practice, BioSocieties (2009), 4, 61–77, London School of Economics and Political Science doi:10.1017/S1745855209006437
Focus on brain activity and cognition • Findings from cognitive neuroscience have revealed new insights into how mental processes emerge from the activity of the brain • Do mental processes [language] not also emerge in response to present cultural and ecological living conditions?
Lack of body-mind unity • How self-conscious can we be if parts of our body are numb and feel wooden when touched, limiting our ability to experience the possibilities associated with this disowned part of our bodymind? • Cohen (1993) says that the brain is the last to know. • Lopsided association of consciousness with the brain (excluded: role of cellular memory of the whole body as container of a person‘s consciousness)
Summary of points of criticism • Belief that it is possible to do objective and value-free research • Lopsided focus on early experiences (excluded: effects of current cultural, economic, and ecological living conditions) • Many neuroscience scholars continue to use pathologising and stigmatising language and terms such as ‗dysfunctions, disorders, and treatments‘
The future: ‗neuroart‘? • ‘Neuroart’: • Integrates neuroscience, attachment, and epidemiological research within a network and complexity paradigm • Interprets neuroscience findings such as ‗dysfunctional‘ brain structures and reduced information flows not as a problem but as life-saving adaptive processes • Expands research on ‗neuropeptides‘ into areas of research such as epigenetics and the role of genetic code creation and sharing • Is ‗self-critical‘ of its research methodologies and role in society
The body as mind
The brain is everywhere • Neurons, immune cells, endocrine cells,and many others synthesise, store, and secrete neuropeptides (which should not be called neuropeptides anymore for this very reason). • They should be called by their names such as cytokines, chemokines, lymphokines, interleukines • ‗These substances‘ inform the brain about what is going on in particular cells. • They can even alter the permeability of the brain‘s surface to get access to other receptors deep inside the brain. • According to Pert (1997, p. 185) the mind is the network that holds the psychological, endocrine, and immune system together.
Neuropeptides • Neuropeptides are small protein-like molecules used by neurons to communicate with each other. They are neuronal signaling molecules. The brain largely functions by virtue of neuropeptides. • Neuropeptides are expressed and released by neurons, and mediate or modulate neuronal communication by acting on cell surface receptors. The human genome contains about 90 genes that encode precursors of neuropeptides. • http://www.neuropeptides.nl/ • http://www.youtube.com/watch?v=cOSLvTWjebw • http://www.youtube.com/watch?v=bEcdGK4DQSg • http://www.youtube.com/watch?v=8ysG9ay8TAs
Lindley: The Soma Publisher: CreateSpace Independent Publishing Platform (July 25, 2010) • There is now extant scientific evidence suggesting that nature has evolved a number of molecular acquired inheritance mechanisms. It seems that Lamarck was right after all! In Soma, Dr Robyn Lindley provides us with an easy to understand and quite sobering account of what the new genetics is telling us... "What the mother ate, can determine whether mice pups have a yellow coat, a brown coat or a mottled yellow and brown coat." "You are what your parents ate. Well sometimes" "Smoking and chemicals in the work place can cause sperm damage for generations to come." "Repeated behaviours are inherited." ...and much more! We ignore the consequences at our peril. Learn why scientists now believe that acquired inheritance effects are real.
Robyn Lindley‘s soma blog • What we are also discovering is that many aspects of our own lives can have a lasting impact on our evolution as a species. What we eat, what diseases we develop, how we behave to our young and to each other, and what we do can all alter our genome. Even your cigarettes or sunbaking can leave a specific genetic marker behind in your genes. So there we have it, Lamarckian forces are at work, and we are only just beginning to understand how this occurs, and what it means. • http://thesomablog.com/
Epigenetics • In biology, and specifically genetics, epigenetics is the study of changes in gene expression or cellular phenotype, caused by mechanisms other than changes in the underlying DNA sequence. • Gene expression can be controlled through the action of repressor proteins that attach to silencer regions of the DNA. These changes may remain through cell divisions for the remainder of the cell's life and may also last for multiple generations. However, there is no change in the underlying DNA sequence of the organism; instead, non-genetic factors cause the organism's genes to behave (or "express themselves") differently. • http://en.wikipedia.org/wiki/Epigenetics
The world as mind
Sharing of learning through the dissemination of genetic code • In the world's oceans, 90% of the biomass is microbial, with viruses turning over 20% of that daily. Without the turnover of biomass driven by viruses, many sources of food would not be present for other organisms. • As bacteria are incredibly diverse, then the viruses that infect them, phages, are even more diverse. As bacteria inhabit almost every niche of the earth, so do viruses. • https://www.boundless.com/microbiology/viruses-2/viral-ecology/viral-roles-in-ecosystems/
Sharing of gene fragments (Pollmann, 1977) • Gene sharing through viruses and other mechanisms (peptides?): ▫ Maintains high levels of biodiversity ▫ Represents an intraspecies and interspecies information sharing and learning system ▫ Accelerates adaptation to changing ecological environments ▫ Is the oldest language of the planet ▫ Creates illness in only about 10% of cases after the transfer and incorporation of newly acquired genetic code into an organism (so-called infection)
Integration of ‗antigen‘ and ‗neuropeptide‘ functionalities • Although antigens do initiate immune responses and cytokines do regulate immune processes, a wide array of recent research demonstrates that there are bidirectional communication pathways between the immune system and central nervous system (CNS), with each providing important regulatory control over the other. • http://people.auc.ca/brodbeck/4007/article6.pdf
References • Cohen, B.B. (1993). Sensing, feeling, and action. Northhampton, MA: Contact. • Doidge, N. (2007). The brain that changes itself. Melbourne, VIC: Scribe • Lindley, R. (2010). Soma. Createspace/amazon.com. • Pert, C. (1997) Molecules of emotion. New York: Scribner. • Pollmann, W. (1977). Viren, Botschafter lebender Systeme: eine Einführung in die Virusforschung, Munich: Piper. • Siegel, D. (????) An interpersonal neurobiology of psychotherapy: The developing mind and the resolution of trauma.??? • Slaby, J. (2010). Steps towards a critical neuroscience. Phenom Cogn Sci (2010) 9:397–416DOI 10.1007/s11097010-9170-2
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